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General NPI Number Information
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NPI Number | 1669483707
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Entity Type | Organization
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Legal Business Name | PINKSTONS DRUG STORE INC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 302 MAIN ST
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City | TIFTON
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State | GA
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Zip | 31794-4814
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Country | US
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Telephone | 229-382-5252
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Fax | 229-388-1145
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Provider Business Mailing Address
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Address Line | 302 MAIN ST
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City | TIFTON
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State | GA
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Zip | 31794-4814
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Country | US
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Telephone | 229-382-5252
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Fax | 229-388-1145
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. RICHARD DAVIS GARRETT JR.
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Credential | R PH
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Telephone | 229-382-5252
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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 | PHRE000784
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License Number State | GA
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