Organization
MIMBS DRUG CO.
Active
Other names
Dixie City Pharmacy # 4
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE H MIMBS RPH (PRESIDENT)
(770) 965-9101
Entity
Organization
Contact information
Practice address
4251-H WINDER HWY, FLOWERY BRANCH, GA 30542-4623
(770) 965-9101
(770) 965-9658
Mailing address
4251-H WINDER HWY, FLOWERY BRANCH, GA 30542-4623
(770) 965-9101
(770) 965-9658
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE008007
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00714887A
—
GA
01
—
1142998
NCPDP #
GU
01
—
PHRE008007
STATE LISC NUMBER
GU
Enumeration date
12/27/2005
Last updated
03/07/2023
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