Vidalia Pharmacy Inc

NPI 1114969342 - Pharmacy - 3336L0003X

NPI Details
NPI 1114969342
Enumeration Date 06/12/2006
Last Updated 05/04/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name W W
Position OWNER
Phone (912) 537-4134
Fax (912) 537-4169
Practice Location
209 JACKSON ST
VIDALIA GA, 30474-4713, US
Phone (912) 537-4134
Fax (912) 537-4169
Business Location
209 JACKSON ST
VIDALIA GA, 30474-4713, US
Phone (912) 537-4134
Fax (912) 537-4169
Toxanomy
Taxonomy Code 3336L0003X
License State
License Number
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According to our database, Vidalia Pharmacy Inc NPI is 1114969342, taxonomy code is 3336L0003X Vidalia Pharmacy Inc physically located at 209 Jackson St, Vidalia GA, 30474-4713. NPI Number 1033115704 has the healthcare provider type.

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1114969342 NPI number is provided on an as is basis without warranty of any kind. 1114969342 is maintained by the National Plan & Provider Enumeration System. The contents of Vidalia Pharmacy Inc are for informational purposes only.