Open Gate Pharmacy #3

LBN: Joseliglo Inc
Open Gate Pharmacy #3 is an health care organization with primary practice located at 4519 Woodruff Rd Ste 16 , Columbus GA 31904-6091. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Joseliglo Inc can be contacted via phone (706) 225-0022, or through Evbuomwan, Mojisola via phone (706) 323-0306.

Contact Information

Primary practice address
4519 Woodruff Rd Ste 16 Columbus GA 31904-6091
Phone: (706) 225-0022
Fax: (706) 225-0020
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 PHRE010162 Georgia

Profile Details

NPI number 1881998318
LBN Legal business name Joseliglo Inc
DBA Doing business as Open Gate Pharmacy #3
Authorized official Evbuomwan, Mojisola PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 23rd, 2010
Last updated Jun 23rd, 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 1881998318 NPPES
Other 2153699 PK
MEDICAID 003167027A PK

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