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Contact Information

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
1900 TEBEAU STREET
WAYCROSS, GA31501-5246
 Phone: 912-287-2640
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MAYO CLINIC HEALTH SYSTEM IN WAYCROSS

NPI # 1831393107
LBN Legal business name MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
Authorized official BENJAMIN WHEELER - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 06/12/2007
Last updated 03/07/2023 - About 3 years ago
Identifiers
GA License # PHRE005914
GA Other 108000306 MEDCO
GA Other 1155476 NCPDP
GA Other PHRE005914 PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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