Organization
OKEFENOKEE PHARMACY OF WAYCROSS, LLC
Active
Other names
Guardian Pharmacy of Waycross, LLC, Batten's Prescription Shoppe Long-Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE CARTER MCDONALD III PHARM.D (CHIEF EXECUTIVE MANAGER/CO-OWNER)
(912) 283-1646
Entity
Organization
Contact information
Practice address
1401 ALICE ST, WAYCROSS, GA 31501-4528
(912) 283-1646
(912) 283-5383
Mailing address
1401 ALICE ST, WAYCROSS, GA 31501-4528
(912) 283-1646
(912) 283-5383
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000219051A
—
GA
01
—
PHRE010869
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
01/15/2024
Last updated
01/15/2024
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