Organization
BOONES PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD BAGWELL JR. (PRESIDENT)
(912) 422-3334
Entity
Organization
Contact information
Practice address
37 ALBANY AVE E, PEARSON, GA 31642
(912) 422-3334
(912) 422-3904
Mailing address
PO BOX 699, PEARSON, GA 31642-0699
(912) 422-3334
(912) 422-3904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PGRE005394
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000022184A
—
GA
Enumeration date
11/07/2006
Last updated
10/07/2008
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