Broxton Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Broxton, GA
NPI 1801201447 · NPPES record last updated Sep 8, 2014
Key facts
- NPI
- 1801201447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE010064 (GA)
- Legal business name
- BROXTON PHARMACY LLC
- Practice address
- 402 Alabama St N
Broxton, GA 31519-6001 - Phone
- (912) 359-2362
- Fax
- (912) 359-3607
- NPI assigned
- Jun 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Freddie Pridgen
- Title
- Owner
- Phone
- (912) 359-2362
National Provider Directory
Locations
402 Alabama St N
Broxton, GA 31519
Phone (912) 359-2362
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHRE010064 | GA | Yes |
Addresses
Primary practice location
402 Alabama St N
Broxton, GA 31519-6001
Mailing address
402 Alabama St N
Broxton, GA 31519-6001
Phone (912) 359-2362
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2146466 | Other | PK |
Other names
- Broxton Pharmacy,LLC
Other providers in Broxton, GA
- Broxton Family Pharmacy LLC
- Terri Rae Cater
- Anslee Morgan Collins
- Bridgett De'Neisha Davis
- Filipinas Durano
- Family Medical Associates-Claxton, Inc
All providers in Broxton, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.