Organization
TY COBB HEALTHCARE SYSTEM LONG TERM CARE PHARMACY
Active
Other names
TY COBB LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MCDONALD PHARM.D. (DIRECTOR)
(706) 245-1271
Entity
Organization
Contact information
Practice address
521 FRANKLIN SPRINGS ST, ROYSTON, GA 30662-3934
(706) 245-1467
(706) 245-1421
Mailing address
521 FRANKLIN SPRINGS ST, ROYSTON, GA 30662-3934
(706) 245-1467
(706) 245-1421
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHRE005718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00059562B
—
GA
01
—
1126095
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/06/2005
Last updated
01/25/2013
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