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HENRY W YOUNGBLOOD NPI 1871620211


NPI Information

NPI: 1871620211
Provider Name: HENRY W YOUNGBLOOD

Doing Business As: BROXTON PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
402 ALABAMA ST N
BROXTON, GA
ZIP 31519
Phone: (912) 359-2362
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HENRY W YOUNGBLOOD is a community/retail pharmacy pharmacy in Broxton, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. HENRY W YOUNGBLOOD NPI is 1871620211. The provider is registered as an organization entity type.
The provider Is Doing Business As Broxton Pharmacy.

The provider's business location address is:

402 ALABAMA ST N
BROXTON, GA
ZIP 31519-001
Phone: (912) 359-2362
Fax: (912) 359-3607

The provider's authorized official is Henry Youngblood .
The authorized official title is Owner and has the following contact phone number (912) 359-2362.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 10/14/2014.


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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPHRE010064GEORGIAYes

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
12012944OTHERPK
2000025858AMEDICAIDGEORGIA

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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