# MAGNOLIA DRUG CO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861114217
- **Authorized official:** DR. MATTHEW TANNER PHARMD (CEO)
- **Authorized official phone:** (912) 422-3631

## Contact information

- **Practice address:** 112 N CHURCH ST STE A, HOMERVILLE, GA 31634-2448
- **Practice address phone:** (912) 470-7277
- **Practice address fax:** (912) 244-6679
- **Mailing address:** PO BOX 608, PEARSON, GA 31642-0608
- **Mailing address phone:** (912) 422-3631
- **Mailing address fax:** (912) 422-6104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2022
- **Last updated:** 05/17/2023