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Organization
HENRY W YOUNGBLOOD
Active
Organization
HENRY W YOUNGBLOOD
Active
Other names
BROXTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY YOUNGBLOOD (OWNER)
(912) 359-2362
Entity
Organization
Contact information
Practice address
402 ALABAMA ST N, BROXTON, GA 31519-6001
(912) 359-2362
(912) 359-3607
Mailing address
PO BOX 758, BROXTON, GA 31519-0758
(912) 359-2362
(912) 359-3607
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010064
GA
Other
Enumeration date
02/27/2007
Last updated
10/14/2014
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