# PAULDING MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WellStar Pharmacy Network Store \#4
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770865248
- **Authorized official:** T. MARK HANEY (SITE ADMINISTRATOR)
- **Authorized official phone:** (770) 445-4411

## Contact information

- **Practice address:** 600 W MEMORIAL DR, WELLSTAR PAULDING HOSPITAL, DALLAS, GA 30132-4117
- **Practice address phone:** (770) 443-4780
- **Practice address fax:** (770) 443-4782
- **Mailing address:** WELLSTAR PAULDING HOSPITAL, 600 W. MEMORIAL DRIVE, DALLAS, GA 30132
- **Mailing address phone:** (770) 443-4780
- **Mailing address fax:** (770) 443-4782

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009764 | GA | Yes |

## Other

- **Enumeration date:** 09/12/2011
- **Last updated:** 09/12/2011