Organization
HARBIN CLINIC LLC
Active
Other names
Harbin Clinic Cancer Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TODD PLEDGER (DIR OF PHCY, AO)
(762) 235-2440
Entity
Organization
Contact information
Practice address
255 W 5TH ST SW, ROME, GA 30165-2817
(706) 528-9096
(706) 528-9098
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-2440
(706) 528-9098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009742
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112033A
—
GA
01
—
2128968
PK
—
Enumeration date
03/25/2011
Last updated
02/05/2019
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