Healthcare Provider Details

I. General information

NPI: 1639138373
Provider Name (Legal Business Name): RINNS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BROAD STREET
BUENA VISTA GA
31803-0411
US

IV. Provider business mailing address

PO BOX 474
BUENA VISTA GA
31803-0474
US

V. Phone/Fax

Practice location:
  • Phone: 229-649-2811
  • Fax: 229-649-6100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHRE003552
License Number StateGA

VIII. Authorized Official

Name: BECKY POWELL
Title or Position: MANAGER
Credential:
Phone: 229-649-2811