Organization
THE MEDICINE OF HAZLEHURST LLC
Active
Other names
MEDICINE CABINET OF HAZLEBURST LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JON MEEKS (OWNER)
(912) 383-0634
Entity
Organization
Contact information
Practice address
63 E JEFFERSON ST, HAZLEHURST, GA 31539-6435
(912) 379-9979
(912) 379-9982
Mailing address
63 E JEFFERSON ST, HAZLEHURST, GA 31539-6435
(912) 379-9979
(912) 379-9982
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009050
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076903698C
—
GA
01
—
1149841
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/11/2006
Last updated
07/21/2011
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