Organization
MALCOLMS DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. STANLEY SMITH RPH (PRESIDENT)
(912) 384-1898
Entity
Organization
Contact information
Practice address
250 PETERSON AVE S, DOUGLAS, GA 31533-5237
(912) 384-1898
(912) 383-7109
Mailing address
250 PETERSON AVE S, DOUGLAS, GA 31533-5237
(912) 384-1898
(912) 383-7109
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031237A
—
GA
01
—
1109277
NABP NUMBER
GA
Enumeration date
12/15/2006
Last updated
08/22/2020
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