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General NPI Number Information
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NPI Number | 1669440962
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Entity Type | Organization
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Legal Business Name | HOMER DRUGS, LLC
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 1228 HISTORIC HOMER HWY
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City | HOMER
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State | GA
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Zip | 30547
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Country | US
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Telephone | 706-677-3223
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Fax | 706-677-3602
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Provider Business Mailing Address
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Address Line | 1228 HISTORIC HOMER HWY
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City | HOMER
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State | GA
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Zip | 30547
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Country | US
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Telephone | 706-677-3223
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Fax | 706-677-3602
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER RYAN GURLEY
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Credential | PHARM D
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Telephone | 706-677-3223
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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 | PHRE010390
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License Number State | GA
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