Organization
MED VAULT INC
Active
Other names
Medvault Compounding & Retail Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHINYERE NWEGBO PHARMD (CEO/PIC)
(470) 377-4462
Entity
Organization
Contact information
Practice address
5060 ALLATOONA GTWY, ACWORTH, GA 30101-4906
(470) 377-4462
(678) 744-2849
Mailing address
4621 WATERS EDGE LN NW, ACWORTH, GA 30101-6238
(470) 377-4462
(678) 744-2849
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
10/09/2025
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