Organization
WILSON'S PHARMACY OF CANTON, INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM WILSON R.PH (OWNER)
(770) 720-7450
Entity
Organization
Contact information
Practice address
231 RIVERSTONE PKWY, SUITE 107, CANTON, GA 30114-2463
(770) 720-7450
(770) 479-4443
Mailing address
231 RIVERSTONE PKWY, SUITE 107, CANTON, GA 30114-2463
(770) 720-7450
(770) 479-4443
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007502
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00537105A
—
GA
01
—
1139105
NCPDP #
GA
Enumeration date
11/08/2006
Last updated
03/07/2023
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