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STATE OF DADE LLC NPI 1770188849


NPI Information

NPI: 1770188849
Provider Name: STATE OF DADE, LLC

Doing Business As: MAGNOLIA PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2251018

Address:
4626 BATTLEFIELD PARKWAY
RINGGOLD, GA
ZIP 30736
Phone: (706) 841-0444
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STATE OF DADE, LLC is a community/retail pharmacy pharmacy in Ringgold, 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. STATE OF DADE, LLC NPI is 1770188849. The provider is registered as an organization entity type.
The provider Is Doing Business As Magnolia Pharmacy.

The provider's business location address is:

4626 BATTLEFIELD PARKWAY
RINGGOLD, GA
ZIP 30736
Phone: (706) 841-0444
Fax: (706) 841-0442

The provider's authorized official is Dustin Beard .
The authorized official title is Owner and has the following contact phone number (423) 718-8521.

The CLIA number assigned to this NPI record is 11D2251018 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/4/2020 and was last updated on 1/4/2021.


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
13336C0003XPharmacyCommunity/Retail PharmacyYes

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.