EAST GA SPECIALTY PHARMACY NPI 1609263631

NPI Information

  • NPI: 1609263631
  • Provider Name: EAST GA SPECIALTY PHARMACY
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 400 E GRADY ST
    STATESBORO, GA
    ZIP 30458
  • Phone: (912) 655-9080

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NPI Details

EAST GA SPECIALTY PHARMACY is a pharmacy in Statesboro, GA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. EAST GA SPECIALTY PHARMACY NPI is 1609263631. The provider is registered as an organization entity type.

The provider's business location address is:

400 E GRADY ST
STATESBORO, GA
ZIP 30458-157
Phone: (912) 655-9080

The provider's authorized official is Barbara Aimar Goodwin .
The authorized official title is Owner and has the following contact phone number (912) 655-9080.

The enumeration date for this NPI number is 4/16/2015 and was last updated on 4/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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