Organization
SWEET ONION PHARMACY
Active
Other names
Sweet Onion Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE OLIVER (OWNER)
(912) 537-4747
Entity
Organization
Contact information
Practice address
2321 E 1ST ST, VIDALIA, GA 30474-8811
(912) 537-4747
(912) 537-4846
Mailing address
PO BOX 872, MOUNT VERNON, GA 30445-0872
(912) 583-4108
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009533
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156024
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
834397069A
—
GA
Enumeration date
08/21/2007
Last updated
09/28/2011
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