Organization
WOODYS LONGBRANCH PHARMACY INC
Active
Other names
Woody's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WOODY (OWNER/PRESIDENT)
(678) 316-3031
Entity
Organization
Contact information
Practice address
130 LONG BRANCH RD, DAHLONEGA, GA 30533-7132
(706) 867-9493
(706) 867-9495
Mailing address
WOODY'S LONGBRANCH PHARMACY, P.O. BOX 309, DAHLONEGA, GA 30533
(706) 867-9493
(706) 867-9495
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009678
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1160340
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/20/2010
Last updated
03/01/2011
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