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Contact Information

MEDICAL CENTER PRESCRIPTION SHOP
710 MEDICAL CENTER DR
EASTMAN, GA31023
 Phone: 478-374-5514
 Fax: 478-374-8617
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MEDICAL CENTER PRESCRIPTION SHOP

NPI Number 1598721086
LBN Legal business name MEDICAL CENTER PRESCRIPTION SHOP
Authorized official MICHAEL DWOZAN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/24/2006
Last updated 07/27/2025 - About 10 months ago
Identifiers
GA License # PHRE006118
GA Medicaid 00031864A
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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