Organization
QUINATE PHARMACY LLC
Active
Other names
Southern Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY LEAVITT (MANAGING PARTNER)
(912) 509-3330
Entity
Organization
Contact information
Practice address
1557 POOLER PKWY, SUITE 400, POOLER, GA 31322
(912) 988-3005
Mailing address
1557 POOLER PKWY STE 400, POOLER, GA 31322-4389
(912) 988-3005
(912) 988-1674
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010716
STATE BOARD OF PHARMACY
GA
Enumeration date
03/22/2019
Last updated
05/22/2020
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