Organization
DENNARD INC
Active
Other names
Dennards LTC
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE DENNARD (VP/OWNER)
(912) 529-2021
Entity
Organization
Contact information
Practice address
804 SECOND ST, SOPERTON, GA 30457-2402
(912) 529-2021
(912) 529-2031
Mailing address
804 SECOND ST, SOPERTON, GA 30457-2402
(912) 529-2021
(912) 529-2031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009683
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100424A
—
GA
01
—
2126572
PK
—
Enumeration date
09/17/2010
Last updated
09/19/2025
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