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Organization
HEPHZIBAH PHARMACY LLC
Active
Organization
HEPHZIBAH PHARMACY LLC
Active
Other names
HEPHZIBAH PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FLAKES BS PHARMACY (OWNER)
(706) 592-4646
Entity
Organization
Contact information
Practice address
4819 WINDSOR SPRING RD, HEPHZIBAH, GA 30815-4848
(706) 592-4646
(706) 592-4618
Mailing address
PO BOX 265, HEPHZIBAH, GA 30815-0265
(706) 592-4646
(706) 592-4618
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE004580
GA
Other
Enumeration date
02/15/2007
Last updated
04/22/2016
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