Olde Time Pharmacy At Sixes, Llc

LBN: Olde Time Pharmacy At Sixes Llc
Olde Time Pharmacy At Sixes, Llc is an health care organization with primary practice located at 684 Sixes Rd Ste 105 , Holly Springs GA 30115-8720. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Olde Time Pharmacy At Sixes Llc can be contacted via phone (770) 783-0483, or through Sutherland, Shad via phone (770) 783-0483.

Contact Information

Primary practice address
684 Sixes Rd Ste 105 Holly Springs GA 30115-8720
Fax:
Website:
Authorized official contact:
Name: Sutherland, Shad

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009711 Georgia

Profile Details

NPI number 1912208539
LBN Legal business name Olde Time Pharmacy At Sixes Llc
DBA Doing business as Olde Time Pharmacy At Sixes, Llc
Authorized official Sutherland, Shad
Entity Organization
Organization subpart 1 No
Enumeration date Nov 12th, 2010
Last updated Dec 1st, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912208539 NPPES
Other 1160643 NCPDP PROVIDER IDENTIFICATION NUMBER

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