Organization
PINEWOODS
Active
Other names
PINEWOODS MCINTOSH TRAIL CSR
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA MCCOLLUM RPH (EXECUTIVE DIRECTOR)
(770) 358-8250
Entity
Organization
Contact information
Practice address
700 HIGHWAY 341 S, BARNESVILLE, GA 30204-3470
(770) 358-5252
Mailing address
700 HIGHWAY 341 S, BARNESVILLE, GA 30204-3470
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHH007917
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156442
OTHER ID NUMBER
—
Enumeration date
10/24/2007
Last updated
01/11/2008
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