Organization
SOUTHWEST GEORGIA COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE HARRIS MORGAN JR. (CEO)
(229) 336-9334
Entity
Organization
Contact information
Practice address
181 E BROAD ST, CAMILLA, GA 31730-1966
(229) 336-9334
(229) 336-9525
Mailing address
181 E BROAD ST, P.O. BOX 66, CAMILLA, GA 31730-1966
(229) 336-9334
(229) 336-9525
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
009638
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009638
PHARMACY STATE LISCENSE NUMBER
GA
Enumeration date
03/22/2010
Last updated
03/22/2010
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