Organization
MIMBS DRUG CO.
Active
Other names
Dixie City Pharmacy # 5
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE H MIMBS RPH (PRESIDENT)
(770) 536-3108
Entity
Organization
Contact information
Practice address
1079 JESSE JEWELL PKWY SW, GAINESVILLE, GA 30501-6103
(770) 536-3108
(770) 536-2357
Mailing address
1079 JESSE JEWELL PKWY SW, GAINESVILLE, GA 30501-6103
(770) 536-3108
(770) 536-2357
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
008642
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1150173
NCPDP #
ID
01
—
PHRE008642
STATE LISC NO
GU
Enumeration date
12/26/2005
Last updated
03/07/2023
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