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NPI Code Detail

MEDICARE: HUTCHESON MEDICAL CENTER EMPLOYEE PHARMACY

MEDICARE: HUTCHESON MEDICAL CENTER EMPLOYEE PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyPHRE004853GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11121552OTHERGANABP NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3PHRE004853OTHERGAGA PHARMACY LICENSE

General Provider Information

NPI Number : 1942295142
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUTCHESON MEDICAL CENTER EMPLOYEE PHARMACY
Provider Business Mailing Address
First Line : 100 GROSS CRESCENT CIR
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-3643
Country : US
Telephone Number : 706-858-2279
Fax Number : 706-858-2676
Provider Business Practice Location Address
First Line : 100 GROSS CRESCENT CIR
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-3643
Country : US
Telephone Number : 706-858-2279
Fax Number : 706-858-2676
Authorized Official
Title or Position : PHARMACY DIRECTOR
Name : MR. CARL J. HALE
Credential : R.P.H.
Telephone Number : 706-858-2277
Provider Enumeration Date : 09/14/2005
Last Update Date : 08/22/2020

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