Organization
PULASKI STATE PRISON REGIONAL PHARMACY
Active
Parent organization
GEORGIA DEPARTMENT OF CORRECTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DEPARTMENT OF CORRECTIONS
Authorized official
RANDY GOODROE RPH (PHARMACY DIRECTOR)
(478) 783-6097
Entity
Organization
Contact information
Practice address
373 UPPER RIVER RD, HAWKINSVILLE, GA 31036-8898
(478) 783-6097
(478) 783-6252
Mailing address
373 UPPER RIVER RD, HAWKINSVILLE, GA 31036-8898
(478) 783-6097
(478) 783-6252
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PHPR007792
GA
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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