Organization
KILLIAN HILL RX LLC
Active
Other names
KILLIAN HILL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU MARTINEZ PHARMACIST (PHARMACIST IN CHARGE)
(714) 929-9763
Entity
Organization
Contact information
Practice address
1098 BERMUDA RUN STE 5, STATESBORO, GA 30458-0878
(678) 933-8965
Mailing address
7780 WENTWORTH DR, DULUTH, GA 30097-1609
(678) 933-8965
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
08/19/2021
Last updated
09/09/2021
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