Prominence Pharmacy

LBN: Prominence Pharmacy Pc
Prominence Pharmacy is an health care organization with primary practice located at 131 Prominence Ct Ste 140 , Dawsonville GA 30534-8933. 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. Prominence Pharmacy Pc can be contacted via phone (706) 265-1332, or through Haile, Yohannes via phone (706) 265-1332.

Contact Information

Primary practice address
131 Prominence Ct Ste 140 Dawsonville GA 30534-8933
Phone: (706) 265-1332
Fax: (706) 265-1333
Website:
Map and Directions
Authorized official contact:
Name: Haile, Yohannes
Phone: (706) 265-1332

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE010263 Georgia

Profile Details

NPI number 1821456997
LBN Legal business name Prominence Pharmacy Pc
DBA Doing business as Prominence Pharmacy
Authorized official Haile, Yohannes
Entity Organization
Organization subpart 1 No
Enumeration date Feb 4th, 2016
Last updated Apr 17th, 2017 - about 9 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 1821456997 NPPES
Georgia MEDICAID 003172822A
Georgia Other 2157940

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