Organization
BLACK BEAR PHARMACY, INC.
Active
Organization
BLACK BEAR PHARMACY, INC.
Active
Parent organization
BLACK BEAR PHARMACY, INC.
Other names
PHD Pharmacy LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLACK BEAR PHARMACY, INC.
Authorized official
LOREN PIERCE (OWNER)
(770) 474-7693
Entity
Organization
Contact information
Practice address
110 KEITH ST SW STE 1AND2, CLEVELAND, TN 37311-5868
(423) 614-6650
Mailing address
PO BOX 580, MCDONOUGH, GA 30253-0580
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
02/03/2020
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