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Organization

CAMILLA PHARMACY INC

Active
Other names
camilla pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEN F REYNOLDS R.PH. (PRESIDENT)
(229) 336-8474
Entity
Organization

Contact information

Practice address
92 E BROAD ST, CAMILLA, GA 31730-1832
(229) 336-8474
(229) 336-5602
Mailing address
PO BOX 33, CAMILLA, GA 31730-0033
(229) 336-8474
(229) 336-5602

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHRE003289
GA
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE003289
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00022701A
GA
05
00022701B
GA
01
1107235
NCPDP
Enumeration date
07/01/2006
Last updated
01/28/2011
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