Provider Demographics
NPI:1508544701
Name:WYNNS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:WYNNS HEALTH SERVICES LLC
Other - Org Name:WYNNS PHARMACY LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARMD
Authorized Official - Phone:770-227-9432
Mailing Address - Street 1:566 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4212
Mailing Address - Country:US
Mailing Address - Phone:770-227-9432
Mailing Address - Fax:770-229-4078
Practice Address - Street 1:566 S 8TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4212
Practice Address - Country:US
Practice Address - Phone:770-227-9432
Practice Address - Fax:770-229-4078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYNNS HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-07
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy