FCI JESUP NPI 1508538679

NPI Information

  • NPI: 1508538679
  • Provider Name: FCI JESUP
  • Classification: Clinic/Center - 261QP2400X
  • Specialization: Prison Health
  • Entity Type: Organization
  • CLIA Number: 11D0702661
  • Address: 2600 HIGHWAY 301 SOUTH
    JESUP, GA
    ZIP 31599
  • Phone: (912) 427-0870

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NPI Details

FCI JESUP is a prison health clinic center in Jesup, GA. FCI JESUP NPI is 1508538679. The provider is registered as an organization entity type.

The provider's business location address is:

2600 HIGHWAY 301 SOUTH
JESUP, GA
ZIP 31599-001
Phone: (912) 427-0870

The provider's authorized official is Patrick Tully .
The authorized official title is Chief Pharmacist and has the following contact phone number (912) 427-0870.

The CLIA number assigned to this NPI record is 11D0702661 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/28/2021 and was last updated on 9/28/2021.

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
13336C0002XPharmacyClinic PharmacyNo
2261QP2400XClinic/CenterPrison HealthYes

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: 3/30/2025

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