Organization · Type 2 NPI

Southwell Pharmacy

Community/Retail Pharmacy · Tifton, GA

NPI number 1407911613 Active

Practice location

1802 Lee Avenue
Tifton, GA 31794

Fax (229) 353-6531

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1407911613
Entity type: Organization (Type 2)
Issued: Dec 27, 2006
Last updated: Aug 13, 2025
Status: Active
Subpart: Yes of Tift Regional Health System, Inc.

Other names

<unavail>
Tift Regional Employee Pharmacy · doing business as
Tift Regional Employee Pharmacy · doing business as
Tift Regional Employee Pharmacy · former legal business name

Authorized official

Christopher Keith Dorman
CEO
(229) 382-7120

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407911613

Southwell Pharmacy's National Provider Identifier is 1407911613, issued on Dec 27, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Tifton, GA. The record was last updated on Aug 13, 2025.