Healthcare Provider Details

I. General information

NPI: 1104836261
Provider Name (Legal Business Name): FORSHEE/CARDER PHARMACIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 CHATTANOOGA ROAD
DALTON GA
30720
US

IV. Provider business mailing address

PO BOX 5047
MERIDIAN MS
39302-5047
US

V. Phone/Fax

Practice location:
  • Phone: 706-278-6600
  • Fax:
Mailing address:
  • Phone: 800-447-4095
  • Fax: 601-482-7490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHRE006116
License Number StateGA

VIII. Authorized Official

Name: T FORSHEE
Title or Position: OWNER
Credential:
Phone: 706-278-6600