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Organization

MEDEQUIP HEALTH CORP

Active
Other names
MEDICAL CENTER WEST COMPDING LAB
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE W PULLIAM (PHARMACIST)
(706) 855-5502
Entity
Organization

Contact information

Practice address
465 N BELAIR RD, 1A2, EVANS, GA 30809-3188
(706) 855-5502
(706) 854-2425
Mailing address
465 N BELAIR RD, STE 1A2, EVANS, GA 30809-3188
(706) 855-5502
(706) 854-2425

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHRE009484
GA

Other

Enumeration date
08/19/2008
Last updated
08/19/2008
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