Organization
LOWER OCONEE COMMUNITY HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PEYTON A. SMITH (CEO)
(912) 523-5113
Entity
Organization
Contact information
Practice address
111 NORTH THIRD STREET, GLENWOOD, GA 30428
(912) 523-5113
(912) 523-5036
Mailing address
PO BOX 398, 111 NORTH THIRD STREET, GLENWOOD, GA 30428
(912) 523-5113
(912) 523-5036
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008539
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1149702
NCPDP #
GA
Enumeration date
07/24/2006
Last updated
12/28/2009
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