Organization
PHILLIPS DRUGS, INC
Active
Other names
Phillips Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER HALL GOURLEY R.PH. (PHARMACIST)
(912) 537-3049
Entity
Organization
Contact information
Practice address
306 W 1ST ST, VIDALIA, GA 30474-3369
(912) 537-3049
(912) 537-3040
Mailing address
PO BOX 120, VIDALIA, GA 30475-0120
(912) 537-3049
(912) 537-3040
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE003663
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00033228A
—
GA
01
—
1115369
NCPDP
GA
Enumeration date
12/26/2006
Last updated
01/09/2014
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