Organization
PIERCE FAMILY PHARMACY INC
Active
Other names
Pierce Family Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ZAVAIN MARDIROSSIAN (PRESIDENT,PIC, AO)
(912) 449-1400
Entity
Organization
Contact information
Practice address
3150 US HIGHWAY 84, BLACKSHEAR, GA 31516-4944
(912) 449-1400
(912) 449-1404
Mailing address
3150 US HIGHWAY 84, BLACKSHEAR, GA 31516-4944
(912) 449-1400
(912) 449-1404
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009610
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122314
PK
—
05
—
391060474A
—
GA
Enumeration date
10/13/2009
Last updated
07/19/2018
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