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Southern Pain Institute P C
Compounding Pharmacy in Fayetteville, Georgia
NPI 1750665584

Southern Pain Institute P C is a Compounding Pharmacy based in Fayetteville, GA and is specialized in Compounding Pharmacy. Southern Pain Institute P C practices in Fayetteville, GA. The NPI Number for Southern Pain Institute P C is 1750665584 and holds a License No. (Georgia).

The current practice location address for Southern Pain Institute P C is 1975 Highway 54 W Ste 100, Fayetteville, GA and can be reached out via phone at 770-631-5158 and via fax at 770-632-3731.

Location: 1975 Highway 54 W Ste 100, Fayetteville, GA, 30214-4794
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750665584
Provider Name
Southern Pain Institute P C
Credential
Provider Entity Type
Organization
Address
1975 Highway 54 W Ste 100, Fayetteville, GA, 30214-4794
Phone Number
770-631-5158
Fax Number
770-632-3731
Provider Enumeration Date
09/28/2011
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1161784 01 NCPDP PROVIDER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
1975 Highway 54 W Ste 100
City
Fayetteville
State
Georgia
Zip
30214-4794
Phone Number
770-631-5158
Fax Number
770-632-3731
person
Provider Business Mailing Address Details
Address
1975 Highway 54 W Ste 100
City
Fayetteville
State
Georgia
Zip
30214-4794
Phone Number
770-631-5158
Fax Number
770-632-3731
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
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 2
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
PHRE009784 (Georgia)
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 3
Type
Suppliers
Classification
Pharmacy
Speciality
Compounding Pharmacy
Taxonomy
3336C0004X
License No.
()
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
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