Wellstar Pharmacy Network Store #4

LBN: Paulding Medical Center
Wellstar Pharmacy Network Store #4 is an health care organization with primary practice located at 600 W Memorial Dr Wellstar Paulding Hospital, Dallas GA 30132-4117. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Paulding Medical Center can be contacted via phone (770) 443-4780, or through Haney, T. Mark via phone (770) 445-4411.

Contact Information

Primary practice address
600 W Memorial Dr Wellstar Paulding Hospital Dallas GA 30132-4117
Phone: (770) 443-4780
Fax: (770) 443-4782
Website:
Map and Directions
Authorized official contact:
Name: Haney, T. Mark
Phone: (770) 445-4411

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009764 Georgia

Profile Details

NPI number 1770865248
LBN Legal business name Paulding Medical Center
DBA Doing business as Wellstar Pharmacy Network Store #4
Authorized official Haney, T. Mark
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2011
Last updated Sep 12th, 2011 - about 15 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 1770865248 NPPES
Georgia MEDICAID 000001438B
Georgia Other 1161722

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