Organization
WINNERSVILLE PHARMACY LLC
Active
Other names
Amerimed Long-Term Care Packaging
Organization subpart
No
Provider details
NPI number
Authorized official
TROY ALLEN (GENERAL MANAGER)
(229) 253-0067
Entity
Organization
Contact information
Practice address
3782 OLD US HIGHWAY 41 N, SUITE B, VALDOSTA, GA 31602-6834
(229) 249-0100
(229) 253-9010
Mailing address
PO BOX 4824, VALDOSTA, GA 31604-4824
(229) 253-0067
(229) 219-1588
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PHRE010063
GA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148607
PK
—
Enumeration date
09/29/2014
Last updated
01/06/2016
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