Organization
GEORGIA OXYGEN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ED HILL (OWNER)
(229) 423-7809
Entity
Organization
Contact information
Practice address
611 S GRANT ST, FITZGERALD, GA 31750-3315
(229) 424-0018
Mailing address
PO BOX 750, FITZGERALD, GA 31750-0750
(229) 424-0018
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
333600000X
Pharmacy
PHRE008222
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00838219B
—
GA
01
—
PHRE008222
PHARMACY LICENSE
GA
Enumeration date
03/20/2007
Last updated
03/12/2008
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