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Organization

CUSTOM PHARMACY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ERIC JAMISON HOLGATE RPH (PHARMACIST)
(706) 737-3955
Entity
Organization

Contact information

Practice address
1202 TOWN PARK LANE, SUITE 200, EVANS, GA 30809
(706) 737-3955
(706) 737-6323
Mailing address
1543 15TH STREET, AUGUSTA, GA 30901
(706) 737-3955
(706) 373-6323

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
01/09/2014
Last updated
01/09/2014
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