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Organization
BLAKELY PHARMACY LLC
Active
Organization
BLAKELY PHARMACY LLC
Active
Other names
Hall Drug Co.
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH BRUNER (PIC)
(229) 723-3441
Entity
Organization
Contact information
Practice address
90 COURT SQ, BLAKELY, GA 39823-2340
(229) 723-3441
(229) 723-8707
Mailing address
PO BOX 909, BLAKELY, GA 39823-0909
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE010001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000028784A
—
GA
01
—
2146842
PK
—
Enumeration date
12/20/2006
Last updated
12/07/2016
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