Organization
FOREST HEIGHTS PHARMACY INC
Active
Other names
FOREST HEIGHTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEN ROSS PHARM D (OWNER)
(912) 489-7979
Entity
Organization
Contact information
Practice address
4439 COUNTRY CLUB RD, STATESBORO, GA 30458-9188
(912) 489-7979
(912) 489-6744
Mailing address
PO BOX 2698, STATESBORO, GA 30459-2698
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009034
GA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016295
PK
—
Enumeration date
09/07/2006
Last updated
01/24/2017
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