Organization
STATE OF DADE, LLC
Active
Other names
Magnolia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN BEARD PHARM D. (OWNER)
(423) 718-8521
Entity
Organization
Contact information
Practice address
4626 BATTLEFIELD PARKWAY, RINGGOLD, GA 30736
(706) 841-0444
(706) 841-0442
Mailing address
578 CLASSIC TRL, RINGGOLD, GA 30736-5895
(423) 718-8521
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003243037A
—
GA
Enumeration date
12/04/2020
Last updated
06/24/2025
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