Organization
HARDIES DRUG STORE INC
Active
Other names
HARDIES DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BRIDGES (OWNER/PRESIDENT)
(912) 375-2545
Entity
Organization
Contact information
Practice address
38 S TALLAHASSEE ST, STE 1, HAZLEHURST, GA 31539-6261
(912) 375-2545
(912) 375-0632
Mailing address
38 S TALLAHASSEE ST, STE 1, HAZLEHURST, GA 31539-6261
(912) 375-2545
(912) 375-0632
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00545047A
—
GA
01
—
1110751
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2005
Last updated
06/08/2022
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