Organization
CLINIC DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE FOUCHE' PINNELL PHARM.D. (CO-OWNER)
(229) 924-2783
Entity
Organization
Contact information
Practice address
1001 E FORSYTH ST, AMERICUS, GA 31709-3721
(229) 924-2783
(229) 924-9220
Mailing address
1001 E FORSYTH ST, PO BOX 445, AMERICUS, GA 31709-3721
(229) 924-2783
(229) 924-9220
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
003303
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00025088A
—
GA
01
—
1104481
NABP/NCPDP
—
Enumeration date
03/14/2006
Last updated
07/07/2025
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