Organization
HOLLY SPRINGS PHARMACY LLC
Active
Other names
Pharmoore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MARQUESS (OWNER)
(770) 948-3133
Entity
Organization
Contact information
Practice address
3422 SIXES RD STE 302, CANTON, GA 30114-9126
(770) 213-3341
(770) 213-3294
Mailing address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(678) 285-0760
(770) 971-0315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135011A
—
GA
01
—
2176500
PK
—
Enumeration date
04/06/2018
Last updated
04/06/2018
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