Organization
STAN'S PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY SMITH PHARMACIST (CEO/OWNER)
(912) 367-1155
Entity
Organization
Contact information
Practice address
438 W PARKER ST, BAXLEY, GA 31513-0649
(912) 367-1155
(912) 367-1132
Mailing address
438 W PARKER ST, BAXLEY, GA 31513-0649
(912) 367-1155
(912) 367-1132
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008226
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00784451B
—
GA
Enumeration date
06/28/2006
Last updated
08/22/2020
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