Provider Demographics
NPI:1659162964
Name:THE CORPORATION OF MERCER UNIVERSITY
Entity type:Organization
Organization Name:THE CORPORATION OF MERCER UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. VICE PRESIDENT FOR ADMINISTRA
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:NETHERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-301-2710
Mailing Address - Street 1:1550 COLLEGE STREET
Mailing Address - Street 2:MUSM DEANS SUITE
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31207
Mailing Address - Country:US
Mailing Address - Phone:478-301-4070
Mailing Address - Fax:
Practice Address - Street 1:750 HAZEL STREET
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-334-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORPORATION OF MERCER UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy