National Provider Identifier Database

MEDICAL CENTER PRESCRIPTION SHOP
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

MEDICAL CENTER PRESCRIPTION SHOP
710 MEDICAL CENTER DR
EASTMAN, GA31023
Phone: 478-374-5514
Fax: 478-374-8617
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for MEDICAL CENTER PRESCRIPTION SHOP

NPI Number 1598721086
Legal business name
LBN
MEDICAL CENTER PRESCRIPTION SHOP
Authorized official MICHAEL DWOZAN - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/24/2006
Last updated 07/27/2025 - About 10 months ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHRE006118
  • GA Medicaid: 00031864A

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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