Organization
SHERWOOD CLINICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY CARTER (GM, OWNER)
(706) 776-9127
Entity
Organization
Contact information
Practice address
415 FISK AVE, DEMOREST, GA 30535-6053
(706) 776-9127
(706) 894-2808
Mailing address
415 FISK AVE, DEMOREST, GA 30535-6053
(706) 776-9127
(706) 894-2808
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHRE007370
GA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHHH000008
GA
333600000X
Pharmacy
PHHH000008
GA
3336C0002X
Clinic Pharmacy
PHHH000008
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00493688C
—
GA
Enumeration date
12/26/2007
Last updated
03/17/2018
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