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General NPI Number Information
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NPI Number | 1609949924
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE PHARMACY
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 793 E MAIN ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4576
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Country | US
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Telephone | 706-632-2244
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Fax | 706-642-4440
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Provider Business Mailing Address
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Address Line | 793 E MAIN ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4576
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Country | US
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Telephone | 706-632-2244
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Fax | 706-642-4440
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Authorized Official
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Title or Position | PHARMACIST
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Name | CHRIS L HONEYCUTT
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Credential | R.PH.
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Telephone | 706-632-2244
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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 | PHRE005892
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License Number State | GA
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