# PIONEER HEALTH SERVICES OF EARLY COUNTY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pioneer Community Hospital of Early
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043301872
- **Authorized official:** WADE COOK (DIR OF PHCY)
- **Authorized official phone:** (229) 724-4208

## Contact information

- **Practice address:** 11740 COLUMBIA ST, BLAKELY, GA 39823-2574
- **Practice address phone:** (229) 724-4208
- **Practice address fax:** (229) 724-4268
- **Mailing address:** 11740 COLUMBIA ST, BLAKELY, GA 39823-2574
- **Mailing address phone:** (229) 724-4208
- **Mailing address fax:** (229) 724-4268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE09691 | GA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 07/02/2015