Organization
JL BURCH,LLC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK LEE BURCH R.PH. (PHARMACIST)
(770) 386-7004
Entity
Organization
Contact information
Practice address
101 MERCHANTS SQUARE DR, CARTERSVILLE, GA 30121-2258
(770) 386-7004
(770) 386-7523
Mailing address
101 MERCHANTS SQUARE DR, CARTERSVILLE, GA 30121-2258
(770) 386-7004
(770) 386-7523
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008431
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00878512A
—
GA
01
—
1147582
NCPDP
GA
Enumeration date
12/19/2006
Last updated
03/07/2023
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