Organization
CARMICHAELS VITAL CARE PHARMACY INC
Active
Other names
Carmichael's Vital Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA HICKMAN (OWNER)
(770) 267-2559
Entity
Organization
Contact information
Practice address
150-D MLK JR. BLVD, MONROE, GA 30655
(770) 266-2937
(770) 207-5886
Mailing address
150-D MLK JR. BLVD, MONROE, GA 30655
(770) 266-2937
(770) 207-5886
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
000045
GA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121867
PK
—
Enumeration date
08/25/2009
Last updated
05/15/2026
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