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PRUITTHEALTH PHARMACY SERVICES - CHRISTIAN CITY LLC NPI 1952638579


NPI Information

NPI: 1952638579
Provider Name: PRUITTHEALTH PHARMACY SERVICES - CHRISTIAN CITY, LLC

Doing Business As: PRUITTHEALTH PHARMACY SERVICES - CHRISTIAN CITY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 11D2204552

Address:
7300 LESTER RD
BLDG P
UNION CITY, GA
ZIP 30291
Phone: (770) 210-5900
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PRUITTHEALTH PHARMACY SERVICES - CHRISTIAN CITY, LLC is a long term care pharmacy pharmacy in Union City, 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 - CHRISTIAN CITY, LLC NPI is 1952638579. The provider is registered as an organization entity type.
The provider Is Doing Business As Pruitthealth Pharmacy Services - Christian City.

The provider's business location address is:

7300 LESTER RD
BLDG P
UNION CITY, GA
ZIP 30291-328
Phone: (770) 210-5900
Fax: (770) 500-1116

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

The CLIA number assigned to this NPI record is 11D2204552 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/4/2009 and was last updated on 6/3/2021.


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
1291U00000XClinical Medical LaboratoryNo
23336C0003XPharmacyCommunity/Retail PharmacyPHRE009656GEORGIANo
33336I0012XPharmacyInstitutional PharmacyPHRE009656GEORGIANo
43336L0003XPharmacyLong Term Care PharmacyPHRE009656GEORGIAYes

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
1474085527AMEDICAIDGEORGIA
21160023OTHERGEORGIANCPDP

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.