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General NPI Number Information
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NPI Number | 1164730669
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Entity Type | Organization
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Legal Business Name | DENNARD INC
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 804 SECOND ST
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City | SOPERTON
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State | GA
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Zip | 30457-2402
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Country | US
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Telephone | 912-529-2021
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Fax | 912-529-2031
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Provider Business Mailing Address
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Address Line | 804 SECOND ST
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City | SOPERTON
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State | GA
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Zip | 30457-2402
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Country | US
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Telephone | 912-529-2021
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Fax | 912-529-2031
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Authorized Official
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Title or Position | VP/OWNER
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Name | BLAKE DENNARD
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Credential |
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Telephone | 912-529-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHRE009683
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License Number State | GA
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