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Organization

MARKETPLACE PHARMACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL GONZALEZ RPH. (PHARMACIST IN CHARGE)
(706) 384-2085
Entity
Organization

Contact information

Practice address
9205 LAVONIA RD, CARNESVILLE, GA 30521-3203
(706) 384-3995
Mailing address
PO BOX 355, 9205 LAVONIA RD., CARNESVILLE, GA 30521
(706) 384-2085
(706) 384-2225

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE010393
GA

Other

Enumeration date
05/10/2012
Last updated
01/28/2022
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