Organization
AUTRY STATE PRISON PHARMACY
Active
Parent organization
GEORGIA DEPARTMENT OF CORRECTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DEPARTMENT OF CORRECTIONS
Authorized official
DEENA JONES GAINOUS PHARMD (PHARMACY DIRECTOR)
(229) 294-6786
Entity
Organization
Contact information
Practice address
3178 MOUNT ZION CHURCH RD, PELHAM, GA 31779
(229) 294-6786
(229) 294-6788
Mailing address
PO BOX 648, PELHAM, GA 31779-0648
(229) 294-6786
(229) 294-6788
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PHPR007470
GA
Other
Enumeration date
05/16/2018
Last updated
05/23/2018
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