Organization Name: | MEDCTR INC |
NPI Number: | 1245299973 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KYLE PULLIAM (PRESIDENT/PHARMACIST) |
Mailing Address: | 465 N Belair Rd Suite 1a Evans |
State: | GA US |
Postal Code: | 308093188 |
Phone Number: | 7068542424 |
Fax Number: | 7068542425 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 05/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | PHRE008412 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy 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. |