Organization
WINNERSVILLE PHARMACY, LLC
Active
Other names
AMERIMED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TROY ALLEN (GENERAL MANAGER)
(229) 253-0067
Entity
Organization
Contact information
Practice address
3782 OLD US HIGHWAY 41 N, SUITE C, VALDOSTA, GA 31602-6834
(229) 253-0067
(229) 219-1588
Mailing address
PO BOX 4824, VALDOSTA, GA 31604-4824
(229) 253-0067
(229) 219-1588
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010062
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148299
PK
—
Enumeration date
09/16/2014
Last updated
02/20/2017
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