Organization
ADVANCED MEDICAL GROUP LLC
Active
Other names
Wrens Drug
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE RAWLINS (VP)
(678) 689-2389
Entity
Organization
Contact information
Practice address
206 E BROAD ST, WRENS, GA 30833-1109
(706) 547-2225
(706) 547-3012
Mailing address
PO BOX 1860, LANGLEY, SC 29834-1860
(706) 547-2225
(888) 273-1488
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010430
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175805
PK
—
05
—
744933579A
—
GA
Enumeration date
02/09/2018
Last updated
05/17/2018
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