Healthcare Provider Details

I. General information

NPI: 1679532634
Provider Name (Legal Business Name): RLS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 S SCOTT ST
BAINBRIDGE GA
39819-8702
US

IV. Provider business mailing address

823 S SCOTT ST
BAINBRIDGE GA
39819-8702
US

V. Phone/Fax

Practice location:
  • Phone: 229-246-1200
  • Fax: 229-243-8146
Mailing address:
  • Phone: 229-246-1200
  • Fax: 229-243-8146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHRE005585
License Number StateGA

VIII. Authorized Official

Name: RICHARD L SMITH
Title or Position: OWNER
Credential: RPH
Phone: 229-246-1200