Organization
SKIDAWAY VILLAGE PHARMACY INC
Active
Other names
VILLAGE WALK PHARMACY LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CONLEY (PRESIDENT)
(912) 598-8669
Entity
Organization
Contact information
Practice address
1 SKIDAWAY VILLAGE WALK, SAVANNAH, GA 31411-2908
(912) 598-8669
(912) 598-7208
Mailing address
1 SKIDAWAY VILLAGE WALK, SAVANNAH, GA 31411-2908
(912) 598-8669
(912) 598-7208
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164713
PK
—
Enumeration date
10/11/2016
Last updated
10/20/2016
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