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PRUITTHEALTH PHARMACY SERVICES INC. NPI 1902853112


NPI Information

NPI: 1902853112
Provider Name: PRUITTHEALTH PHARMACY SERVICES, INC.

Doing Business As: PRUITTHEALTH PHARMACY SERVICES - TOCCOA

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 11D2204948

Address:
377 NORTH POND STREET
TOCCOA, GA
ZIP 30577
Phone: (706) 886-7787
Get Directions

PRUITTHEALTH PHARMACY SERVICES, INC. is a long term care pharmacy pharmacy in Toccoa, GA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. PRUITTHEALTH PHARMACY SERVICES, INC. NPI is 1902853112. The provider is registered as an organization entity type.
The provider Is Doing Business As Pruitthealth Pharmacy Services - Toccoa.

The provider's business location address is:

377 NORTH POND STREET
TOCCOA, GA
ZIP 30577-920
Phone: (706) 886-7787
Fax: (706) 886-2939

The provider's authorized official is Neil L Pruitt .
The authorized official title is Chairman And Ceo and has the following contact phone number (770) 279-6200.

The CLIA number assigned to this NPI record is 11D2204948 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 3/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10923360001MEDICARE NSCGEORGIA
20116756MEDICAIDNORTH CAROLINA
300033767AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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