Organization
UNIVERSAL PHARM INC
Active
Other names
DOCTORS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY KEENE PHRM (OWNER)
(478) 472-2040
Entity
Organization
Contact information
Practice address
298 MEDICAL COURT, OGLETHORPE, GA 31068
(478) 472-2040
(912) 472-9822
Mailing address
PO BOX 322, OGLETHORPE, GA 31068-0322
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0036295317
—
GA
01
—
2015889
PK
—
Enumeration date
07/28/2006
Last updated
06/16/2016
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