# DENNARD INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dennards LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164730669
- **Authorized official:** BLAKE DENNARD (VP/OWNER)
- **Authorized official phone:** (912) 529-2021

## Contact information

- **Practice address:** 804 SECOND ST, SOPERTON, GA 30457-2402
- **Practice address phone:** (912) 529-2021
- **Practice address fax:** (912) 529-2031
- **Mailing address:** 804 SECOND ST, SOPERTON, GA 30457-2402
- **Mailing address phone:** (912) 529-2021
- **Mailing address fax:** (912) 529-2031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHRE009683 | GA | Yes |

## Other

- **Enumeration date:** 09/17/2010
- **Last updated:** 09/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003100424A | — | GA |
| 01 | — | 2126572 | PK | — |