Healthcare Provider Details

I. General information

NPI: 1669440962
Provider Name (Legal Business Name): HOMER DRUGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 HISTORIC HOMER HWY
HOMER GA
30547
US

IV. Provider business mailing address

1228 HISTORIC HOMER HWY
HOMER GA
30547
US

V. Phone/Fax

Practice location:
  • Phone: 706-677-3223
  • Fax: 706-677-3602
Mailing address:
  • Phone: 706-677-3223
  • Fax: 706-677-3602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHRE010390
License Number StateGA

VIII. Authorized Official

Name: CHRISTOPHER RYAN GURLEY
Title or Position: OWNER
Credential: PHARM D
Phone: 706-677-3223