OLDE TIME PHARMACY AT SIXES LLC NPI 1831476316

NPI Information

  • NPI: 1831476316
  • Provider Name: OLDE TIME PHARMACY AT SIXES, LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 684 SIXES RD
    SUITE 105
    HOLLY SPRINGS, GA
    ZIP 30115
  • Phone: (678) 445-4486

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NPI Details

OLDE TIME PHARMACY AT SIXES, LLC is a clinic center in Holly Springs, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). OLDE TIME PHARMACY AT SIXES, LLC NPI is 1831476316. The provider is registered as an organization entity type.

The provider's business location address is:

684 SIXES RD
SUITE 105
HOLLY SPRINGS, GA
ZIP 30115-721
Phone: (678) 445-4486
Fax: (678) 445-3536

The provider's authorized official is Shad Sutherland .
The authorized official title is Manager and has the following contact phone number (678) 445-4486.

The enumeration date for this NPI number is 11/10/2011 and was last updated on 11/10/2011.

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
1261Q00000XClinic/CenterPHRE009711GEORGIAYes

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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