# DOGWOOD PHARMACY LTC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DOGWOOD PHARMACY LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245799857
- **Legal business name:** DOGWOOD PHARMACY LLC
- **Authorized official:** LAURA EUGENA TYSON (PHARMACIST/OWNER)
- **Authorized official phone:** (229) 316-8200

## Contact information

- **Practice address:** 1909 US HIGHWAY 82 W STE 11, TIFTON, GA 31793-8213
- **Practice address phone:** (229) 256-2411
- **Practice address fax:** (229) 256-2488
- **Mailing address:** 1909 US HIGHWAY 82 W STE 11, TIFTON, GA 31793-8213
- **Mailing address phone:** (229) 256-2411
- **Mailing address fax:** (229) 256-2488

## Taxonomy

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

## Other

- **Enumeration date:** 03/14/2019
- **Last updated:** 04/04/2019