Organization
RIVER EDGE BEHAVIORAL HEALTH CENTER
Active
Other names
RIVER EDGE BEHAVIORAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN LAYMAN RPH (PHCY DIRECTOR/PIC)
(478) 803-7650
Entity
Organization
Contact information
Practice address
175 EMERY HWY, MACON, GA 31217-3692
(478) 803-7696
(478) 746-5864
Mailing address
175 EMERY HWY, MACON, GA 31217-3692
(478) 803-7696
(478) 746-5864
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE005543
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604986A
—
GA
01
—
2019177
PK
—
Enumeration date
09/06/2006
Last updated
01/17/2017
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