Organization
SATILLA LIFE CARE
Active
Other names
SATILLA HEALTH ENTERPRISES, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN RANDOLPH WHEELER RPH (DEPT. HEAD)
(912) 287-2506
Entity
Organization
Contact information
Practice address
2007 TEBEAU ST, WAYCROSS, GA 31501-6358
(912) 285-9153
Mailing address
2007 TEBEAU ST, WAYCROSS, GA 31501-6358
(912) 285-9153
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE00764
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE00764
STATE LICENSE
GA
Enumeration date
07/12/2005
Last updated
09/06/2023
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