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Organization
PRESBYTERIAN HOME PHARMACY INC
Active
Organization
PRESBYTERIAN HOME PHARMACY INC
Active
Other names
PRESBYTERIAN HOME PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX PATTERSON MS (EXCTV DIR)
(229) 263-6101
Entity
Organization
Contact information
Practice address
1901 W SCREVEN ST, QUITMAN, GA 31643-3913
(229) 263-6130
(229) 263-6169
Mailing address
PO BOX 407, QUITMAN, GA 31643-0407
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PHRE005010
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00142579B
—
GA
01
—
2017528
PK
—
Enumeration date
01/30/2007
Last updated
12/08/2020
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