# BAZE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BAZE Specialty Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689029951
- **Authorized official:** ATHELIA EZE (OWNER)
- **Authorized official phone:** (662) 323-5033

## Contact information

- **Practice address:** 1526 E FORREST AVE STE 102, EAST POINT, GA 30344-6979
- **Practice address phone:** (404) 761-4448
- **Practice address fax:** (404) 761-7905
- **Mailing address:** 900 STARK RD, STARKVILLE, MS 39759-3613
- **Mailing address phone:** (662) 323-5579
- **Mailing address fax:** (662) 323-5053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE010285 | GA | Yes |
| 3336L0003X | Long Term Care Pharmacy | PHRE010285 | GA | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/25/2016
- **Last updated:** 03/29/2017