MEDICARE: TAYLOR PHARMACY GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1386357051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR PHARMACY GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 95
Second Line	:
City	:	SAINT GEORGE
State	:	GA
Zip	:	31562-0095
Country	:	US
Telephone Number	:	912-843-8280
Fax Number	:	912-843-2456

Provider Business Practice Location Address
First Line	:	12995 FLORIDA AVE STE B
Second Line	:
City	:	SAINT GEORGE
State	:	GA
Zip	:	31562-3265
Country	:	US
Telephone Number	:	912-843-8280
Fax Number	:	912-843-2456

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. JILLIAN BROOKE TAYLOR
Credential	:	PHARMD
Telephone Number	:	912-288-1898

Provider Enumeration Date	:	12/27/2022
Last Update Date	:	12/27/2022

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