# NURSING HOME PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NURSING HOME PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780680652
- **Authorized official:** JOHN GLEATON BS PHARMACY (PARTNER)
- **Authorized official phone:** (770) 267-8677

## Contact information

- **Practice address:** 1865 BOLD SPRINGS RD NW, MONROE, GA 30656-4605
- **Practice address phone:** (770) 267-8677
- **Practice address fax:** (770) 267-6462
- **Mailing address:** 1865 BOLD SPRINGS RD NW, MONROE, GA 30656-4605
- **Mailing address phone:** (770) 267-8677
- **Mailing address fax:** (770) 267-6462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHRE004071 | GA | Yes |

## Other

- **Enumeration date:** 06/24/2005
- **Last updated:** 08/02/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00002164 | — | GA |
| 01 | — | 2012681 | PK | — |