Organization
CLINIC DRUG STORE
Active
Other names
PLAINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LEE PINNELL (VP/PIC)
(229) 924-2783
Entity
Organization
Contact information
Practice address
103 MAIN ST, PLAINS, GA 31780-0160
(229) 824-5255
(229) 824-3703
Mailing address
103 MAIN ST, PO BOX 160, PLAINS, GA 31780-0160
(229) 824-5255
(229) 824-3703
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE000223
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168216
PK
—
Enumeration date
02/14/2007
Last updated
06/09/2017
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