Organization
HOLLY SPRINGS PHARMACY LLC
Active
Other names
PharMoore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MARQUESS RPH (OWNER/RPH/AO)
(678) 285-0760
Entity
Organization
Contact information
Practice address
3422 SIXES RD STE 106, CANTON, GA 30114-9120
(770) 213-3341
(770) 213-3294
Mailing address
3422 SIXES RD STE 106, CANTON, GA 30114-9120
(770) 213-3341
(770) 213-3294
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135011A
—
GA
01
—
2170893
PK
—
Enumeration date
03/04/2012
Last updated
07/19/2018
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