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Organization

MAGNOLIA MANOR PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. J ANDREW HILL JR. RPH PHARMACIST (PRESIDENT)
(478) 783-1515
Entity
Organization

Contact information

Practice address
2001 S LEE ST, AMERICUS, GA 31709
(229) 924-9352
(229) 931-5956
Mailing address
2001 SOUTH LEE ST, AMERICUS, GA 31709
(229) 924-9352
(229) 931-5956

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
002260
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00040785A
GA
01
1147950
NCPDP
GA
01
1147950
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
01/05/2007
Last updated
04/16/2008
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