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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
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