Organization
SOUTHWELL PHARMACY
Active
Parent organization
TIFT REGIONAL HEALTH SYSTEM, INC.
Other names
Tift Regional Employee Pharmacy, Tift Regional Employee Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
TIFT REGIONAL HEALTH SYSTEM, INC.
Authorized official
CHRISTOPHER KEITH DORMAN (CEO)
(229) 382-7120
Entity
Organization
Contact information
Practice address
1802 LEE AVENUE, TIFTON, GA 31794
(229) 353-6756
(229) 353-6531
Mailing address
1802 LEE AVENUE, TIFTON, GA 31794
(229) 353-6756
(229) 353-6531
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1117539
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
PHRE010721
LICENSE
GA
Enumeration date
12/27/2006
Last updated
08/13/2025
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