# WOODBINE MEDICAL, LLC

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

## Provider details

- **NPI number:** 1821661034
- **Authorized official:** RYAN CLEMENTS PHARM.D (MEMBER / CEO)
- **Authorized official phone:** (912) 464-7186

## Contact information

- **Practice address:** 908 GEORGIA AVE STE 1, WOODBINE, GA 31569-3574
- **Practice address phone:** (912) 576-6998
- **Practice address fax:** (912) 729-7275
- **Mailing address:** PO BOX 729, WOODBINE, GA 31569-0729
- **Mailing address phone:** (912) 576-6998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/24/2021
- **Last updated:** 07/24/2021