Provider Demographics
NPI:1346830270
Name:WESTMINSTER PRESBYTERIAN HOMES, INC.
Entity Type:Organization
Organization Name:WESTMINSTER PRESBYTERIAN HOMES, INC.
Other - Org Name:PRESBYTERIAN VILLAGE ATHENS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRENDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-263-6194
Mailing Address - Street 1:PO BOX 926
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-0926
Mailing Address - Country:US
Mailing Address - Phone:229-263-6106
Mailing Address - Fax:229-263-6195
Practice Address - Street 1:1400 LIVE OAK LANE
Practice Address - Street 2:BUILDING 100
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3010
Practice Address - Country:US
Practice Address - Phone:706-739-7516
Practice Address - Fax:706-739-7516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTMINSTER PRESBYTERIAN HOME INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-25
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy