Organization
SONORAVILLE PHARMACY, INC.
Active
Other names
Sonoraville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY RALPH JOHNSTON RPH. (PHARMACIST/OWNER)
(706) 383-8604
Entity
Organization
Contact information
Practice address
6824 FAIRMOUNT HWY SE, CALHOUN, GA 30701-4019
(706) 383-8604
(706) 383-8658
Mailing address
6824 FAIRMOUNT HWY SE, CALHOUN, GA 30701-4019
(706) 383-8604
(706) 383-8658
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010145
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010145
STATE LICENSE
GA
Enumeration date
05/09/2015
Last updated
05/09/2015
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