Organization
DOGWOOD PHARMACY LLC
Active
Parent organization
DOGWOOD PHARMACY LLC
Other names
Dogwood Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOGWOOD PHARMACY LLC
Authorized official
LAURA EUGENA TYSON PHARMD (PRESIDENT/OWNER/PHARMACIST)
(229) 686-2620
Entity
Organization
Contact information
Practice address
1909 US HIGHWAY 82 W STE 11, TIFTON, GA 31793-8213
(229) 256-2411
(229) 256-2488
Mailing address
501 N DAVIS ST, NASHVILLE, GA 31639-1426
(229) 237-1462
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010367
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010367
STATE RETAIL PHARMACY LICENSE
GA
Enumeration date
07/21/2017
Last updated
07/21/2017
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