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Organization
MEDICAL CENTER PRESCRIPTION SHOP
Active
Organization
MEDICAL CENTER PRESCRIPTION SHOP
Active
Other names
Prescription Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FREDERICK DWOZAN RPH (CEO)
(478) 374-5514
Entity
Organization
Contact information
Practice address
710 MEDICAL CENTER DR, EASTMAN, GA 31023
(478) 374-5514
(478) 374-8617
Mailing address
710 MEDICAL CENTER DR, EASTMAN, GA 31023
(478) 374-5514
(478) 374-8617
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE006118
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031864A
—
GA
Enumeration date
04/24/2006
Last updated
07/27/2025
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