# GEORGIA PHARMACY VENTURES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAGNOLIA MANOR PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497927321
- **Authorized official:** JAMES LEE RPH (PRESIDENT)
- **Authorized official phone:** (478) 783-4262

## Contact information

- **Practice address:** 342 INDUSTRIAL BLVD, STE C, HAWKINSVILLE, GA 31036-2103
- **Practice address phone:** (478) 783-4262
- **Practice address fax:** (478) 783-8970
- **Mailing address:** PO BOX 998, HAWKINSVILLE, GA 31036-0998
- **Mailing address phone:** (478) 783-4262
- **Mailing address fax:** (478) 783-8970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHRE009471 | GA | Yes |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 09/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2017405 | PK | — |