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Organization
PHILLIPS DRUGS, INC
Active
Organization
PHILLIPS DRUGS, INC
Active
Other names
Phillips Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER HALL GOURLEY R.PH. (PHARMACIST)
(912) 537-3049
Entity
Organization
Contact information
Practice address
306 W 1ST ST, VIDALIA, GA 30474-3369
(912) 537-3049
(912) 537-3040
Mailing address
PO BOX 120, VIDALIA, GA 30475-0120
(912) 537-3049
(912) 537-3040
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE003663
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00033228A
—
GA
01
—
1115369
NCPDP
GA
Enumeration date
12/26/2006
Last updated
01/09/2014
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