Organization
WINN-DIXIE PHARMACY #482
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID NANCE REG PHARMACIST (PHARMACIST IN CHARGE)
(706) 562-8330
Entity
Organization
Contact information
Practice address
1100 HUNT AVENUE, COLUMBUS, GA 31907
(706) 562-8330
Mailing address
1100 HUNT AVENUE, COLUMBUS, GA 31907
(706) 562-8330
(706) 562-0463
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007773
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007773
CERTIFICATE OF OCCUPANCY
GA
01
—
044611
BUSINESS LICENSE
GA
Enumeration date
11/30/2006
Last updated
08/22/2020
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