Healthcare Provider Details

I. General information

NPI: 1902974702
Provider Name (Legal Business Name): CARTERS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 AUGUSTA RD
GARDEN CITY GA
31408-1758
US

IV. Provider business mailing address

4704 AUGUSTA RD
GARDEN CITY GA
31408-1758
US

V. Phone/Fax

Practice location:
  • Phone: 912-965-9911
  • Fax: 912-965-1732
Mailing address:
  • Phone: 912-965-9911
  • Fax: 912-965-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE007680
License Number StateGA

VIII. Authorized Official

Name: AMY CARTER
Title or Position: CEO
Credential:
Phone: 912-748-1414