Organization
PATTERSON PHARMACARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GRIFFIS RPH (CEO)
(912) 647-0777
Entity
Organization
Contact information
Practice address
6460 HWY 84, PATTERSON, GA 31557-5016
(912) 647-0777
(912) 647-0739
Mailing address
6460 HWY 84, PATTERSON, GA 31557-5016
(912) 647-0777
(912) 647-0739
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008957
GA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080073227A
—
GA
01
—
1153371
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
5494820001
MEDICARE NCS
GA
Enumeration date
03/23/2007
Last updated
06/05/2015
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