Organization
SOUTHERN FAMILY MARKETS LLC
Active
Other names
SOUTHERN FAMILY MARKET
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TOW (DIRECTOR OF PHARMACY)
(205) 912-4234
Entity
Organization
Contact information
Practice address
4025 LEXINGTON RD, ATHENS, GA 30605-2527
(706) 613-2244
(706) 613-6030
Mailing address
PO BOX 8500, LOCKBOX 8531, PHILADELPHIA, PA 19178-8531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007673
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000578861A
—
AL
01
—
1153977
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/02/2006
Last updated
10/30/2009
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