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) 912-4934
Entity
Organization
Contact information
Practice address
1425 ROCKY CREEK RD, MACON, GA 31206-3575
(478) 788-3054
Mailing address
PO BOX 8500, LOCKBOX 8531, PHILADELPHIA, PA 19178-8531
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009541
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158179
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
369558283A
—
GA
Enumeration date
01/07/2009
Last updated
10/30/2009
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