Organization
TMC VILLA RICA HOSPITAL, INC
Active
Parent organization
TMC VILLA RICA HOSPITAL, INC
Other names
NW Ga Oncology Ctr Retail Pharmacy - TMC/Villa Rica
Organization subpart
Yes
Provider details
NPI number
Legal business name
TMC VILLA RICA HOSPITAL, INC
Authorized official
CAROL S. CREWS CFO (CFO)
(770) 812-9745
Entity
Organization
Contact information
Practice address
157 CLINIC AVE STE 202, ROOM 219, CARROLLTON, GA 30117-4454
(770) 812-1919
Mailing address
100 PROFESSIONAL PL STE 305, CARROLLTON, GA 30117-3872
(770) 812-8614
(770) 812-8372
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5KYKWKNF2
HEALTH INDUSTRY NUMBER
—
Enumeration date
05/13/2020
Last updated
09/08/2020
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