# WHITLOCK PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHAW PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912068081
- **Authorized official:** TERRY SHAW PHARMD (OWNER PHCST)
- **Authorized official phone:** (770) 427-5647

## Contact information

- **Practice address:** 3880 DUE WEST RD NW, SUITE E, MARIETTA, GA 30064-1058
- **Practice address phone:** (770) 427-5647
- **Practice address fax:** (770) 514-7861
- **Mailing address:** 3880 DUE WEST RD NW, SUITE E, MARIETTA, GA 30064-1058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE006953 | GA | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 03/25/2009