Provider Demographics
NPI:1871223628
Name:BROXTON FAMILY PHARMACY LLC
Entity type:Organization
Organization Name:BROXTON FAMILY PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:912-359-2362
Mailing Address - Street 1:402 ALABAMA ST N
Mailing Address - Street 2:
Mailing Address - City:BROXTON
Mailing Address - State:GA
Mailing Address - Zip Code:31519-6001
Mailing Address - Country:US
Mailing Address - Phone:912-359-2362
Mailing Address - Fax:912-359-2370
Practice Address - Street 1:402 ALABAMA ST N
Practice Address - Street 2:
Practice Address - City:BROXTON
Practice Address - State:GA
Practice Address - Zip Code:31519-6001
Practice Address - Country:US
Practice Address - Phone:912-359-2362
Practice Address - Fax:912-359-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy