Organization
MORTAR & PESTLE, LLC
Active
Other names
The Medicine Cabinet
Organization subpart
No
Provider details
NPI number
Authorized official
JON MEEKS (OWNER/PHARMACIST)
(912) 383-8510
Entity
Organization
Contact information
Practice address
205 VERNON STREET, LAGRANGE, GA 30240
(706) 298-4928
(706) 298-4929
Mailing address
205 VERNON STREET, LAGRANGE, GA 30240
(706) 298-4928
(706) 298-4929
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009938
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136178A
—
GA
01
—
2141011
PK
—
Enumeration date
07/03/2013
Last updated
07/15/2020
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