Organization
BARNES DRUG STORE, LLC
Active
Other names
Barnes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TOLLISON BARNES R.PH. (OWNER PHARMACIST)
(912) 367-7708
Entity
Organization
Contact information
Practice address
694 S MAIN ST, BAXLEY, GA 31513-0124
(912) 367-7708
(912) 367-4732
Mailing address
694 S MAIN ST, BAXLEY, GA 31513-0124
(912) 367-7708
(912) 367-4732
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006375
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00295336A
—
GA
Enumeration date
12/06/2005
Last updated
03/04/2015
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