# CRISP REGIONAL HOSPITAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194129924
- **Authorized official:** LYNN RENEE BEARDEN (DIRECTOR REV INT)
- **Authorized official phone:** (229) 276-3146

## Contact information

- **Practice address:** 902 N 7TH ST, CORDELE, GA 31015
- **Practice address phone:** (229) 276-3386
- **Practice address fax:** (229) 276-3387
- **Mailing address:** 902 N 7TH ST, CORDELE, GA 31015-3234
- **Mailing address phone:** (229) 276-3386
- **Mailing address fax:** (229) 276-3387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | PHH003554 | GA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | — | — |

## Other

- **Enumeration date:** 10/22/2014
- **Last updated:** 09/06/2018