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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