OrganizationActive
Department of Behavioral Health and Developmental Disabilities
NPI 1992036909 · Long Term Care Pharmacy · Gracewood, GA
Provider details
- NPI number
- 1992036909
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Authorized official
- Paul Brock, Regional Hospital Administrator
- License
- PHH004147 (GA)
Practice location
100 Myrtle Blvd
Gracewood, GA 30812-1500
Phone: (706) 790-2496
Fax: (706) 790-2340
Mailing address
100 Myrtle Blvd
Gracewood, GA 30812-1500
Registry dates
- Enumerated
- 2010-01-15
- Last updated
- 2015-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.