Organization
BAKCO ENTERPRISES,INC
Active
Other names
MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE PULLIAM (OWNER PHARMACIST)
(706) 854-2424
Entity
Organization
Contact information
Practice address
3121 PEACH ORCHARD RD, AUGUSTA, GA 30906-3521
(706) 792-5130
(706) 792-5132
Mailing address
3121 PEACH ORCHARD RD, AUGUSTA, GA 30906-3521
(706) 792-5130
(706) 792-5132
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030643A
—
GA
Enumeration date
10/12/2006
Last updated
11/17/2009
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