Organization
CRYSTAL PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTTY JARVIS PHARMD (MANAGING MEMBER)
(229) 985-4137
Entity
Organization
Contact information
Practice address
705 S MAIN ST, MOULTRIE, GA 31768-5432
(229) 985-4137
(229) 890-5968
Mailing address
PO BOX 8, MOULTRIE, GA 31776-0008
(229) 985-4137
(229) 890-5968
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19927
GA
Other
Enumeration date
08/10/2006
Last updated
08/22/2020
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