Healthcare Provider Details

I. General information

NPI: 1073194957
Provider Name (Legal Business Name): NEIGHBORHOOD IMPROVEMENT PROJECT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 GARREDD BLVD
AUGUSTA GA
30909-6752
US

IV. Provider business mailing address

1113 GARREDD BLVD
AUGUSTA GA
30909-6752
US

V. Phone/Fax

Practice location:
  • Phone: 706-447-9896
  • Fax: 706-447-9898
Mailing address:
  • Phone: 706-447-9896
  • Fax: 706-447-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WESLEY WOOD
Title or Position: CFO
Credential:
Phone: 706-790-4440