Healthcare Provider Details

I. General information

NPI: 1467125799
Provider Name (Legal Business Name): HOOK RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARKER AVE N STE 500A
BROOKLET GA
30415-9506
US

IV. Provider business mailing address

400 PARKER AVE N STE 500A
BROOKLET GA
30415-9506
US

V. Phone/Fax

Practice location:
  • Phone: 912-842-2040
  • Fax:
Mailing address:
  • Phone: 912-536-7976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHELBY FOREHAND HOOK
Title or Position: OWNER
Credential:
Phone: 912-536-7976