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General NPI Number Information
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NPI Number | 1548226434
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Entity Type | Organization
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Legal Business Name | OKEFENOKEE PHARMACY OF WAYCROSS, LLC DBA BATTEN'S PRESCRIPTION SHOPPE
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1401 ALICE ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4528
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Country | US
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Telephone | 912-283-1646
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Fax | 912-283-5383
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Provider Business Mailing Address
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Address Line | 1401 ALICE ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4528
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Country | US
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Telephone | 912-283-1646
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Fax | 912-283-5383
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Authorized Official
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Title or Position | EXECUTIVE MANAGER / CO-OWNER
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Name | LEAH MCDONALD
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Credential |
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Telephone | 912-283-1646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE006029
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License Number State | GA
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