Organization
GATEWAY CSB PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY BRIGHT RPH (PIC)
(912) 303-1602
Entity
Organization
Contact information
Practice address
1915 EISENHOWER DR, BLDG 3, SAVANNAH, GA 31406-5027
(912) 351-9343
(912) 351-6437
Mailing address
1915 EISENHOWER DR, BLDG 3, SAVANNAH, GA 31406-5027
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHRE006000
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00864729A
—
GA
01
—
1144980
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/12/2006
Last updated
08/22/2020
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