Organization
THE MEDICINE CABINET OF WAYCROSS DOWNTOWN LLC
Active
Other names
THE MEDICINE CABINET OF WAYCROSS - DOWNTOWN, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JON MEEKS (OWNER)
(912) 383-8510
Entity
Organization
Contact information
Practice address
620 TEBEAU ST, WAYCROSS, GA 31501-4728
(912) 283-2772
(912) 284-0009
Mailing address
620 TEBEAU ST, WAYCROSS, GA 31501-4728
(912) 283-2772
(912) 284-0009
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE005927
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00507064A
—
GA
01
—
2012895
PK
—
Enumeration date
04/19/2006
Last updated
02/20/2017
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