Provider Demographics
NPI:1639116429
Name:CLINE & FORRISTER PHARMACY, INC
Entity Type:Organization
Organization Name:CLINE & FORRISTER PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:DARRELL
Authorized Official - Last Name:FORRISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-777-3373
Mailing Address - Street 1:1 ALABAMA ST
Mailing Address - Street 2:P.O. BOX 70
Mailing Address - City:CAVE SPRING
Mailing Address - State:GA
Mailing Address - Zip Code:30124-2608
Mailing Address - Country:US
Mailing Address - Phone:706-777-3373
Mailing Address - Fax:706-777-3374
Practice Address - Street 1:1 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:CAVE SPRING
Practice Address - State:GA
Practice Address - Zip Code:30124-2608
Practice Address - Country:US
Practice Address - Phone:706-777-3373
Practice Address - Fax:706-777-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA002957OtherRETAIL PHARMACY
5747190001Medicare NSC