Open Gate Pharmacy 1

LBN: Gowyn Inc
Open Gate Pharmacy 1 is an health care organization with primary practice located at 2051 10Th Ave , Columbus GA 31901-1459. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Gowyn Inc can be contacted via phone (706) 323-0306, or through Evbuomwan, Mojisola via phone (706) 323-0306.

Contact Information

Primary practice address
2051 10Th Ave Columbus GA 31901-1459
Phone: (706) 323-0306
Fax: (706) 327-3824
Website:
Map and Directions
Authorized official contact:
Name: Evbuomwan, Mojisola PHARMD
Phone: (706) 323-0306

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009915 Georgia
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1740484179
LBN Legal business name Gowyn Inc
DBA Doing business as Open Gate Pharmacy 1
Authorized official Evbuomwan, Mojisola PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2007
Last updated May 4th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740484179 NPPES
Other 2140755 PK
MEDICAID 00479806A PK

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