Organization
UNIVERSITY HEALTHCARE SYSTEMS EMPLOYEE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD W SEVERSON (DIRECTOR, PHARMACY)
(706) 774-5200
Entity
Organization
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2629
(706) 774-5348
(706) 774-5071
Mailing address
1350 WALTON WAY, AUGUSTA, GA 30901-2629
(706) 774-5348
(706) 774-5071
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE002074
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE002074
PROFESSIONAL LICENSE
GA
Enumeration date
11/21/2007
Last updated
11/21/2007
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