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Organization

PORTER PHARMACY & GIFTS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT A DYKES PHARM.D (STAFF PHARMACIST)
(478) 934-6344
Entity
Organization

Contact information

Practice address
134 N 2ND ST, COCHRAN, GA 31014-6304
(478) 934-6344
(478) 934-8820
Mailing address
134 N 2ND ST, COCHRAN, GA 31014-6304
(478) 934-6344
(478) 934-8820

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
005795
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000363701A
GA
05
300026936A
GA
Enumeration date
12/21/2006
Last updated
08/16/2023
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