Healthcare Provider Details

I. General information

NPI: 1750355269
Provider Name (Legal Business Name): HUGH GENE DENNIS PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 CENTRAL DR
EAST DUBLIN GA
31027-7414
US

IV. Provider business mailing address

5314 FOREST LAKE RD PO BOX 188
EASTMAN GA
31023-6554
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-8024
  • Fax: 478-274-9312
Mailing address:
  • Phone: 478-374-5390
  • Fax: 478-374-7191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH010074
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: