Grimsley Pharmacy

LBN: Mercy Grace Pharmacy
Grimsley Pharmacy is an health care organization with primary practice located at 1508 E Evans St , Bainbridge GA 39819-4364. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mercy Grace Pharmacy can be contacted via phone (229) 246-7733, or through Logue, Randel Elliott via phone (229) 246-7733.

Contact Information

Primary practice address
1508 E Evans St Bainbridge GA 39819-4364
Phone: (229) 246-7733
Fax: (229) 246-7968
Website:
Map and Directions
Authorized official contact:
Name: Logue, Randel Elliott PHARMD
Phone: (229) 246-7733

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE003753 Georgia

Profile Details

NPI number 1841320801
LBN Legal business name Mercy Grace Pharmacy
DBA Doing business as Grimsley Pharmacy
Authorized official Logue, Randel Elliott PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated Jul 21st, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841320801 NPPES
Georgia MEDICAID 000028586A
Georgia Other 1106548

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