Provider Demographics
NPI:1073854741
Name:BARNEY'S PHARMACY AT SERENITY
Entity Type:Organization
Organization Name:BARNEY'S PHARMACY AT SERENITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:RICKARD
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:706-798-5645
Mailing Address - Street 1:3421 MIKE PADGETT HWY
Mailing Address - Street 2:BUILDING A
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3815
Mailing Address - Country:US
Mailing Address - Phone:706-432-7924
Mailing Address - Fax:706-432-7906
Practice Address - Street 1:3421 MIKE PADGETT HWY
Practice Address - Street 2:BUILDING A
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3815
Practice Address - Country:US
Practice Address - Phone:706-432-7924
Practice Address - Fax:706-432-7906
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARNEY'S PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-06
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0099033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy