# MED VAULT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medvault Compounding & Retail Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487410247
- **Authorized official:** CHINYERE NWEGBO PHARMD (CEO/PIC)
- **Authorized official phone:** (470) 377-4462

## Contact information

- **Practice address:** 5060 ALLATOONA GTWY, ACWORTH, GA 30101-4906
- **Practice address phone:** (470) 377-4462
- **Practice address fax:** (678) 744-2849
- **Mailing address:** 4621 WATERS EDGE LN NW, ACWORTH, GA 30101-6238
- **Mailing address phone:** (470) 377-4462
- **Mailing address fax:** (678) 744-2849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2024
- **Last updated:** 10/09/2025