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Organization
KILLIAN HILL RX LLC
Active
Organization
KILLIAN HILL RX LLC
Active
Other names
KILLIAN HILL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU MARTINEZ PHARMACIST (PHARMACIST IN CHARGE)
(714) 929-9763
Entity
Organization
Contact information
Practice address
1098 BERMUDA RUN STE 5, STATESBORO, GA 30458-0878
(678) 933-8965
Mailing address
7780 WENTWORTH DR, DULUTH, GA 30097-1609
(678) 933-8965
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
08/19/2021
Last updated
09/09/2021
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