Provider Demographics
NPI:1497890024
Name:HURLEY INVESTMENTS INC
Entity Type:Organization
Organization Name:HURLEY INVESTMENTS INC
Other - Org Name:DINGLEWOOD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-322-0616
Mailing Address - Street 1:1939 WYNNTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2964
Mailing Address - Country:US
Mailing Address - Phone:706-322-0616
Mailing Address - Fax:706-322-6637
Practice Address - Street 1:1939 WYNNTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2964
Practice Address - Country:US
Practice Address - Phone:706-322-0616
Practice Address - Fax:706-322-6637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
GA0045503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00069726AMedicaid
GA00069726CMedicaid
2012160OtherPK
2012160OtherPK
1108009OtherOTHER ID NUMBER