Organization
SOUTHERN PHARMACY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS RAY HARRISON PHARMD (OWNER)
(912) 294-1684
Entity
Organization
Contact information
Practice address
110 ALLISON ST., JESUP, GA 31545
(912) 559-2961
(912) 559-2597
Mailing address
711 LAMBERT BENNETT RD, JESUP, GA 31546
(912) 294-1684
(912) 559-2597
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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