Organization
BAZE SPECIALTY PHARMACY, LLC
Active
Parent organization
BAZE PHARMACY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAZE PHARMACY, LLC
Authorized official
MRS. ATHELIA BALAMS EZE PHARM D (OWNER/PHARMACIST)
(662) 323-5033
Entity
Organization
Contact information
Practice address
1526 E FORREST AVE, SUITE 102, EAST POINT, GA 30344-6986
(404) 761-4448
(404) 761-7905
Mailing address
900 STARK RD, STARKVILLE, MS 39759-3613
(662) 323-5033
(662) 323-5053
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHRE010285
GA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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