Organization
RIVER EDGE BEHAVIORAL HEALTH CENTER
Active
Other names
River Edge Baldwin County
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN LAYMAN (PHARMACY DIRECTOR)
(478) 451-2784
Entity
Organization
Contact information
Practice address
60 GA HIGHWAY 22 W, MILLEDGEVILLE, GA 31061-6606
(478) 451-2784
(478) 454-3131
Mailing address
60 GA HIGHWAY 22 W, MILLEDGEVILLE, GA 31061-6606
(478) 451-2784
(478) 454-3131
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009803
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604986B
—
GA
01
—
2133695
PK
—
Enumeration date
01/13/2012
Last updated
12/22/2016
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