# BACON COUNTY HEALTH SVC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BACON COUNTY HOSPITAL PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972666576
- **Authorized official:** RICHARD LOTT PHRMD (DIR OF PHRM SRV)
- **Authorized official phone:** (912) 632-8961

## Contact information

- **Practice address:** 302 S WAYNE ST, ALMA, GA 31510-2922
- **Practice address phone:** (912) 632-8961
- **Practice address fax:** (912) 632-2231
- **Mailing address:** 302 S WAYNE ST, PO DRAWER 1987, ALMA, GA 31510-2922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 8086 | GA | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 11/04/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00000118B | — | GA |
| 01 | — | 2013239 | PK | — |