Organization
PRESBYTERIAN HOME PHARMACY INC
Active
Other names
PRESBYTERIAN HOME PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX PATTERSON MS (EXCTV DIR)
(229) 263-6101
Entity
Organization
Contact information
Practice address
1901 W SCREVEN ST, QUITMAN, GA 31643-3913
(229) 263-6130
(229) 263-6169
Mailing address
PO BOX 407, QUITMAN, GA 31643-0407
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE005010
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00142579B
—
GA
01
—
2017528
PK
—
Enumeration date
01/30/2007
Last updated
12/08/2020
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