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Organization

KSYRX

Active
Other names
Mako Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
IBRAHIM SYLLA RPH (OWNER/PIC)
(770) 696-9146
Entity
Organization

Contact information

Practice address
1525 E PARK PLACE BLVD, STE 500, STONE MOUNTAIN, GA 30087
(770) 696-9146
(470) 299-3159
Mailing address
PO BOX 958277, DULUTH, GA 30095-9539
(281) 755-4922
(470) 299-3159

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHHH000060
GA
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2143584
PK
Enumeration date
12/27/2013
Last updated
08/19/2026
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