# QUINATE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Hometown Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053891887
- **Authorized official:** MRS. TRACEY LEAVITT (MANAGING PARTNER)
- **Authorized official phone:** (912) 509-3330

## Contact information

- **Practice address:** 546 W BACON ST, PEMBROKE, GA 31321-4648
- **Practice address phone:** (912) 653-1000
- **Practice address fax:** (912) 295-4667
- **Mailing address:** 1557 POOLER PKWY STE 400, POOLER, GA 31322-4389
- **Mailing address phone:** (912) 653-1000
- **Mailing address fax:** (912) 295-4667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2018
- **Last updated:** 05/27/2020