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Organization
VILLA RICA RX LLC
Active
Organization
VILLA RICA RX LLC
Active
Other names
VILLA RICA DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLTON HAROLD BLACKMON PHARM D (OWNER)
(770) 456-4663
Entity
Organization
Contact information
Practice address
222 WEST WILSON STREET, VILLA RICA, GA 30180
(770) 456-4663
(770) 456-4661
Mailing address
222 WEST WILSON STREET, VILLA RICA, GA 30180
(770) 456-4663
(770) 456-4661
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PHRE009763
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010412
GA
Other
Enumeration date
06/09/2011
Last updated
06/26/2018
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