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Organization

SOUTH GEORGIA MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM M. BRANNEN R.PH. (DIRECTOR OF PHARMACY)
(229) 259-4869
Entity
Organization

Contact information

Practice address
2501 NORTH PATTERSON STREET, VALDOSTA, GA 31603-1727
(229) 259-4869
(229) 259-4872
Mailing address
2501 NORTH PATTERSON STREET, VALDOSTA, GA 31603-1727
(229) 259-4869
(229) 259-4872

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE006396
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHRE006396
PHARMACY LICENSE #
GA
Enumeration date
11/16/2005
Last updated
03/07/2023
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