Organization
MIMBS DRUG CO.
Active
Other names
Dixie City Pharmacy No 3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE H MIMBS RPH (PRESIDENT)
(770) 287-3662
Entity
Organization
Contact information
Practice address
2415-F OLD CORNELIA HIGHWAY, GAINESVILLE, GA 30507-6901
(770) 287-3662
(770) 287-0779
Mailing address
2415-F OLD CORNELIA HIGHWAY, GAINESVILLE, GA 30507
(770) 287-3662
(770) 287-0779
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE007240
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1136236
NCPDP #
GA
01
—
PHRE007240
STATE LISC NO
GU
Enumeration date
12/27/2005
Last updated
03/07/2023
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