Organization
SMITH'S PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JOHNNY BAZEMORE DOCTOR OF PHARMACY (RPH/OWNER)
(478) 862-5655
Entity
Organization
Contact information
Practice address
10 NORTH POPLAR ST, BUTLER, GA 31006
(478) 862-5655
(478) 862-2811
Mailing address
PO BOX 546, BUTLER, GA 31006-0546
(478) 862-5655
(478) 862-2811
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE004545
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00793295A
—
GA
05
—
00793295B
—
GA
Enumeration date
08/16/2006
Last updated
06/26/2008
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