Organization
PROMINENCE PHARMACY PC
Active
Other names
Prominence pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
YOHANNES HAILE (PRESIDENT)
(706) 265-1332
Entity
Organization
Contact information
Practice address
131 PROMINENCE CT STE 140, DAWSONVILLE, GA 30534-8933
(706) 265-1332
(706) 265-1333
Mailing address
131 PROMINENCE CT STE 140, DAWSONVILLE, GA 30534-8933
(706) 265-1332
(706) 265-1333
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010263
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003172822A
—
GA
01
—
2157940
PK
—
Enumeration date
02/04/2016
Last updated
04/17/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us