Lower Oconee Community Hospital Pharmacy

Organization Active NPI Community/Retail Pharmacy · Glenwood, GA

NPI 1063434652 · NPPES record last updated Dec 28, 2009

Key facts

NPI
1063434652
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHRE008539 (GA)
Legal business name
LOWER OCONEE COMMUNITY HOSPITAL PHARMACY
Practice address
111 North Third Street
Glenwood, GA 30428
Phone
(912) 523-5113
Fax
(912) 523-5036
NPI assigned
Jul 24, 2006
Organization subpart
No

Authorized official

Name
Mr. Peyton A. Smith
Title
Ceo
Phone
(912) 523-5113

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lower Oconee Community Hospital Inc (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE008539 GA Yes

Addresses

Primary practice location

111 North Third Street
Glenwood, GA 30428

Mailing address

PO Box 398
111 North Third Street
Glenwood, GA 30428
Phone (912) 523-5113

Other identifiers

IdentifierTypeStateIssuer
1149702OtherGANCPDP #

Other providers in Glenwood, GA

All providers in Glenwood, GA · Community/Retail Pharmacy in Georgia

Sources for this page

Verify at the official NPI Registry.