# PHARMA ST RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124584214
- **Authorized official:** DILLON GREENE (OWNER)
- **Authorized official phone:** (561) 715-1527

## Contact information

- **Practice address:** 519 S SCOTT ST, BAINBRIDGE, GA 39819-4101
- **Practice address phone:** (239) 495-3133
- **Practice address fax:** (229) 329-4432
- **Mailing address:** 519 S SCOTT ST, BAINBRIDGE, GA 39819-4101
- **Mailing address phone:** (229) 495-3133
- **Mailing address fax:** (239) 329-4432

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/14/2019
- **Last updated:** 02/03/2021