Organization
WINNERSVILLE LONG TERM CARE PACKAGING
Active
Other names
AmeriMed Long-Term Care Packaging
Organization subpart
No
Provider details
NPI number
Authorized official
TROY ALLEN (GENERAL MANAGER)
(229) 249-0100
Entity
Organization
Contact information
Practice address
3782 OLD US HIGHWAY 41 N, SUITE B, VALDOSTA, GA 31602-6834
(229) 249-0100
(229) 219-1588
Mailing address
PO BOX 4824, VALDOSTA, GA 31604-4824
(229) 249-0100
(229) 219-1588
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE0100063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139900
PK
—
Enumeration date
04/25/2013
Last updated
12/08/2016
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