Provider Demographics
NPI:1003884255
Name:BWS MAJOR MANAGEMENT SYSTEMS
Entity Type:Organization
Organization Name:BWS MAJOR MANAGEMENT SYSTEMS
Other - Org Name:SCOTT'S PHARMACY # 1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT,PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:478-742-3098
Mailing Address - Street 1:PO BOX 2267
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31203-2267
Mailing Address - Country:US
Mailing Address - Phone:478-742-3098
Mailing Address - Fax:478-750-8575
Practice Address - Street 1:635 PIO NONO AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-3531
Practice Address - Country:US
Practice Address - Phone:478-742-3098
Practice Address - Fax:478-750-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-12
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE 006505332B00000X, 332BP3500X, 3336C0004X, 3336H0001X
GAPHRE006505333600000X, 3336S0011X
GAPHRE0093683336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00309438BMedicaid
GAPHRE 009368OtherGEORGIA PHARMACY LICENSE
GA00309438AMedicaid
GA1129421OtherNABP
GAPHRE 009368OtherGEORGIA PHARMACY LICENSE
GA00309438BMedicaid