Healthcare Provider Details

I. General information

NPI: 1467506212
Provider Name (Legal Business Name): UNION PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 SIBLEY AVE
UNION POINT GA
30669-1140
US

IV. Provider business mailing address

624 SIBLEY AVE P. O. BOX 303
UNION POINT GA
30669-1140
US

V. Phone/Fax

Practice location:
  • Phone: 706-486-2131
  • Fax: 706-486-2132
Mailing address:
  • Phone: 706-486-2131
  • Fax: 706-486-2132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHRE002986
License Number StateGA

VIII. Authorized Official

Name: JAMES CARPENTER
Title or Position: CEO
Credential: RPH
Phone: 706-486-2131