Organization
WIREGRASS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE MICHAEL CLEVELAND RPH. (PHARMACY DIRECTOR)
(334) 684-3655
Entity
Organization
Contact information
Practice address
1200 W. MAPLE AVE, PHARMACY DEPT., GENEVA, AL 36340
(334) 684-3655
(334) 684-1294
Mailing address
1200 W. MAPLE AVE, PHARMACY DEPT., GENEVA, AL 36340
(334) 684-3655
(334) 684-1294
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HOS0062H
—
AL
Enumeration date
05/17/2012
Last updated
05/17/2012
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