Organization
GATEWAY COMMUNITY SVC BOARD
Active
Other names
GATEWAY CSB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY BRIGHT RPH (PIC)
(912) 790-6220
Entity
Organization
Contact information
Practice address
800 E 70TH ST, SAVANNAH, GA 31405-4813
(912) 790-6220
(912) 349-4328
Mailing address
800 E 70TH ST, SAVANNAH, GA 31405-4813
(912) 790-6220
(912) 349-4328
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PHRE006000
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00864729A
—
GA
01
—
1144980
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2006
Last updated
02/07/2013
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