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Dkl31092 Inc
Long Term Care Pharmacy in Montezuma, Georgia
NPI 1104881556

Dkl31092 Inc is a Long Term Care Pharmacy based in Montezuma, GA and is specialized in Long Term Care Pharmacy. Dkl31092 Inc practices in Montezuma, GA. The NPI Number for Dkl31092 Inc is 1104881556 and holds a License No. (Georgia).

The current practice location address for Dkl31092 Inc is 112 S Dooly St, Montezuma, GA and can be reached out via phone at 478-472-7561 and via fax at 478-472-5887.

Location: 112 S Dooly St, Montezuma, GA, 31063-0250
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104881556
Provider Name
Dkl31092 Inc
Credential
Provider Entity Type
Organization
Address
112 S Dooly St, Montezuma, GA, 31063-0250
Phone Number
478-472-7561
Fax Number
478-472-5887
Provider Enumeration Date
04/19/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1112527 01 NCPDP PROVIDER IDENTIFICATION NUMBER
00927649A 05 GA
institution
Provider Business Practice Location Address Details
Address
112 S Dooly St
City
Montezuma
State
Georgia
Zip
31063-1604
Phone Number
478-472-7561
Fax Number
478-472-5887
person
Provider Business Mailing Address Details
Address
112 S Dooly St
City
Montezuma
State
Georgia
Zip
31063-1604
Phone Number
478-472-7561
Fax Number
478-472-5887
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
()
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
PHRE003393 (Georgia)
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
()
Definition
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.
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
()
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
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