Healthcare Provider Details
I. General information
NPI: 1699873620
Provider Name (Legal Business Name): MANOR PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 WARM SPRINGS RD
COLUMBUS GA
31904-7932
US
IV. Provider business mailing address
PO BOX 8828
COLUMBUS GA
31908-8828
US
V. Phone/Fax
- Phone: 706-324-2501
- Fax: 706-324-0900
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | PHRE004294 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RENEE
ADAMSON
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 706-324-0387