Organization
SUMMERVILLE PHARMACY INC
Active
Other names
SUMMERVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROB WOODS (PRESIDENT)
(706) 481-7140
Entity
Organization
Contact information
Practice address
2839 CENTRAL AVE, AUGUSTA, GA 30909-3904
(706) 481-7140
(706) 733-7301
Mailing address
PO BOX 2986, AUGUSTA, GA 30914-2986
(706) 481-7140
(706) 733-7301
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE004193
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000493556C
—
GA
01
—
2013033
PK
—
Enumeration date
06/20/2006
Last updated
07/08/2015
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