Organization
BENNETT'S HOMETOWN PHARMACY - WAYNESVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE BENNETT R.PH. (PHARMACIST)
(912) 462-3784
Entity
Organization
Contact information
Practice address
26826 HWY 82, WAYNESVILLE, GA 31566
(912) 778-3784
Mailing address
PO BOX 1321, NAHUNTA, GA 31553-1321
(912) 778-3784
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE009147
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009147
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
735642371C
—
GA
Enumeration date
06/14/2007
Last updated
07/06/2015
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