Organization
MEDICAL CENTER PHARMACY OF STATESBORO, INC
Active
Parent organization
MEDICAL CENTER PHARMACY OF STATESBORO, INC
Other names
Medical Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL CENTER PHARMACY OF STATESBORO, INC
Authorized official
MR. JAMES LEMUEL NEVIL III RPH (PHARMACIST/OWNER)
(912) 764-5643
Entity
Organization
Contact information
Practice address
57 GRANADE ST, STATESBORO, GA 30458
(912) 764-5643
(912) 764-9580
Mailing address
57 GRANADE ST, STATESBORO, GA 30458
(912) 764-5643
(912) 764-9580
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006387
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031842A
—
GA
Enumeration date
02/25/2007
Last updated
03/07/2023
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