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THE MEDICINE CABINET OF WAYCROSS DOWNTOWN LLC NPI 1861457004


NPI Information

NPI: 1861457004
Provider Name: THE MEDICINE CABINET OF WAYCROSS DOWNTOWN LLC

Doing Business As: THE MEDICINE CABINET OF WAYCROSS - DOWNTOWN, LLC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2270719

Address:
620 TEBEAU ST
WAYCROSS, GA
ZIP 31501
Phone: (912) 283-2772
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THE MEDICINE CABINET OF WAYCROSS DOWNTOWN LLC is a community/retail pharmacy pharmacy in Waycross, 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. THE MEDICINE CABINET OF WAYCROSS DOWNTOWN LLC NPI is 1861457004. The provider is registered as an organization entity type.
The provider Is Doing Business As The Medicine Cabinet Of Waycross - Downtown, Llc.

The provider's business location address is:

620 TEBEAU ST
WAYCROSS, GA
ZIP 31501-728
Phone: (912) 283-2772
Fax: (912) 284-0009

The provider's authorized official is Jon Meeks .
The authorized official title is Owner and has the following contact phone number (912) 383-8510.

The CLIA number assigned to this NPI record is 11D2270719 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 2/20/2017.


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 PharmacyPHRE005927GEORGIAYes
33336C0004XPharmacyCompounding PharmacyNo

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
100507064AMEDICAIDGEORGIA
22012895OTHERPK

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.