Wildwood Sanitarium Incorporated

NPI 1093058265 - Pharmacy - 3336C0003X

NPI Details
NPI 1093058265
Enumeration Date 04/05/2013
Last Updated 11/27/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name SHELLY SHELLY
Position DIRECTOR OF PHARMACY
Phone (706) 419-0023
Fax (706) 820-1474
Practice Location
435 LIFE STYLE LN
WILDWOOD GA, 30757-4174, US
Phone (706) 419-0023
Fax (706) 820-1474
Business Location
435 LIFE STYLE LN
WILDWOOD GA, 30757-4174, US
Phone (706) 419-0023
Fax (706) 820-1474
Toxanomy
Taxonomy Code 3336C0003X
License State Georgia
License Number PHRE009672
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According to our database, Wildwood Sanitarium Incorporated NPI is 1093058265, taxonomy code is 3336C0003X and license number is PHRE009672, license state is located at Georgia. Wildwood Sanitarium Incorporated physically located at 435 Life Style Ln, Wildwood GA, 30757-4174. NPI Number 1033115704 has the healthcare provider type.

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1093058265 NPI number is provided on an as is basis without warranty of any kind. 1093058265 is maintained by the National Plan & Provider Enumeration System. The contents of Wildwood Sanitarium Incorporated are for informational purposes only.