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Contact Information

LITTLE CREEK DRUG LLC
1001 NORTH WAY
DARIEN, GA31305
 Phone: 912-437-6353
 Fax: 912-437-7621
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for LITTLE CREEK DRUG LLC

NPI # 1346263498
LBN Legal business name LITTLE CREEK DRUG LLC
Authorized official TRAVIS HARRISON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/26/2006
Last updated 08/24/2020 - About 6 years ago
Identifiers
GA License # 8398
GA Medicaid 00862672A
Other 1147049 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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