Organization
BLACKSHEAR DRUG CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CAREY MARTIN III RPH (OWNER / PIC)
(912) 449-6616
Entity
Organization
Contact information
Practice address
3487 US HIGHWAY 84, BLACKSHEAR, GA 31516-2293
(912) 449-6616
(912) 449-5759
Mailing address
3487 US HIGHWAY 84, BLACKSHEAR, GA 31516-2293
(912) 449-6616
(912) 449-5759
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009509
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00035934A
—
GA
05
—
00035934C
—
GA
Enumeration date
06/07/2006
Last updated
03/07/2023
Update your record
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