Organization
MCINTYREPHARMACY LLC DBA GLENWOOD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY MCINTYRE (OWNER)
(912) 523-5094
Entity
Organization
Contact information
Practice address
114 E 2ND AVE, GLENWOOD, GA 30428
(912) 523-5094
(912) 523-5137
Mailing address
PO BOX 780, GLENWOOD, GA 30428-0780
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000815712A
—
GA
Enumeration date
02/21/2007
Last updated
06/17/2008
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