Southern Hometown Pharmacy

LBN: Quinate Pharmacy Llc
Southern Hometown Pharmacy is an health care organization with primary practice located at 546 W Bacon St , Pembroke GA 31321-4648. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Quinate Pharmacy Llc can be contacted via phone (912) 653-1000, or through Leavitt, Tracey via phone (912) 509-3330.

Contact Information

Primary practice address
546 W Bacon St Pembroke GA 31321-4648
Phone: (912) 653-1000
Fax: (912) 295-4667
Website:
Map and Directions
Authorized official contact:
Name: Leavitt, Tracey
Phone: (912) 509-3330

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1053891887
LBN Legal business name Quinate Pharmacy Llc
DBA Doing business as Southern Hometown Pharmacy
Authorized official Leavitt, Tracey
Entity Organization
Organization subpart 1 No
Enumeration date Aug 21st, 2018
Last updated May 27th, 2020 - about 6 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 1053891887 NPPES
Georgia Other PHRE010656 GEORGIA BOARD OF PHARMACY

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