National Provider Identifier Database

CARROLLTON ORTHOPAEDIC CLINIC PC
Pharmacy

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.


Contact Information

CARROLLTON ORTHOPAEDIC CLINIC PC
204 ALLEN MEMORIAL DR STE 102
BREMEN, GA30110-2063
Phone: 727-755-0679
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for CARROLLTON ORTHOPAEDIC CLINIC PC

NPI Number 1013376490
Legal business name
LBN
CARROLLTON ORTHOPAEDIC CLINIC PC
Authorized official JAMES GILBERT - (CFO)
Entity Organization
Organization subpart No
Enumeration date 02/15/2016
Last updated 03/03/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 038964
  • GA Medicaid: 000104427
  • Other: 2158424 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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