Provider Demographics
NPI:1871528372
Name:WEST POINT PHARMACY
Entity type:Organization
Organization Name:WEST POINT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-643-3003
Mailing Address - Street 1:721 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833-1527
Mailing Address - Country:US
Mailing Address - Phone:706-643-3003
Mailing Address - Fax:706-643-3004
Practice Address - Street 1:721 3RD AVE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-1527
Practice Address - Country:US
Practice Address - Phone:706-643-3003
Practice Address - Fax:706-643-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008568333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4733600001Medicare ID - Type Unspecified