Provider Demographics
NPI:1770376469
Name:QUALTHERA GEORGIA HOLDINGS, LTD. CO.
Entity type:Organization
Organization Name:QUALTHERA GEORGIA HOLDINGS, LTD. CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENTISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-405-3277
Mailing Address - Street 1:3290 WILLIAMS RD STE BANDC
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-5614
Mailing Address - Country:US
Mailing Address - Phone:706-405-3277
Mailing Address - Fax:706-940-0755
Practice Address - Street 1:3290 WILLIAMS RD STE BANDC
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-5614
Practice Address - Country:US
Practice Address - Phone:706-405-3277
Practice Address - Fax:706-940-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy