Fulghum Drugs

LBN: Southern Pharmacare Llc
Fulghum Drugs is an health care organization with primary practice located at 73 Sw Park Ave , Baxley GA 31513. 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. Southern Pharmacare Llc can be contacted via phone (912) 367-2488, or through Harrison, Travis Ray via phone (912) 294-1684.

Contact Information

Primary practice address
73 Sw Park Ave Baxley GA 31513
Phone: (912) 367-2488
Fax: (912) 367-7235
Website:
Map and Directions
Authorized official contact:
Name: Harrison, Travis Ray PHARM D
Phone: (912) 294-1684

Health care specialties

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

Profile Details

NPI number 1710441621
LBN Legal business name Southern Pharmacare Llc
DBA Doing business as Fulghum Drugs
Authorized official Harrison, Travis Ray PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2019
Last updated Oct 7th, 2022 - about 2 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 1710441621 NPPES
Georgia MEDICAID 000191441A

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