Provider Demographics
NPI:1639138373
Name:RINNS PHARMACY
Entity Type:Organization
Organization Name:RINNS PHARMACY
Other - Org Name:RINNS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-649-2811
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:GA
Mailing Address - Zip Code:31803-0474
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 BROAD STREET
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:GA
Practice Address - Zip Code:31803-0411
Practice Address - Country:US
Practice Address - Phone:229-649-2811
Practice Address - Fax:229-649-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0035523336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00035098AMedicaid
1107071OtherNCPDP PROVIDER IDENTIFICATION NUMBER