QUINATE PHARMACY LLC NPI 1053891887

NPI Information

NPI: 1053891887
Provider Name: QUINATE PHARMACY LLC
Classification: Pharmacy - 3336C0003X
Specialization: Community/Retail Pharmacy
Entity Type: Organization
Doing Business As: SOUTHERN HOMETOWN PHARMACY
CLIA Number: 11D2200418
Address: 546 W BACON ST
PEMBROKE, GA
ZIP 31321
Phone: (912) 653-1000

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NPI Details

QUINATE PHARMACY LLC is a community/retail pharmacy pharmacy in Pembroke, 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. QUINATE PHARMACY LLC NPI is 1053891887. The provider is registered as an organization entity type.
The provider Is Doing Business As Southern Hometown Pharmacy.

The provider's business location address is:

546 W BACON ST
PEMBROKE, GA
ZIP 31321-648
Phone: (912) 653-1000
Fax: (912) 295-4667

The provider's authorized official is Tracey Leavitt .
The authorized official title is Managing Partner and has the following contact phone number (912) 509-3330.

The CLIA number assigned to this NPI record is 11D2200418 - other - jail with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2018 and was last updated on 5/27/2020.

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
1	3336C0003X	Pharmacy	Community/Retail Pharmacy			Yes

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
1	PHRE010656	OTHER	GEORGIA	GEORGIA BOARD OF PHARMACY

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: 11/21/2025

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