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VILLA RICA RX LLC NPI 1619262433


NPI Information

NPI: 1619262433
Provider Name: VILLA RICA RX LLC

Doing Business As: VILLA RICA DRUGS

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2244881

Address:
222 WEST WILSON STREET
VILLA RICA, GA
ZIP 30180
Phone: (770) 456-4663
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VILLA RICA RX LLC is a community/retail pharmacy pharmacy in Villa Rica, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. VILLA RICA RX LLC NPI is 1619262433. The provider is registered as an organization entity type.
The provider Is Doing Business As Villa Rica Drugs.

The provider's business location address is:

222 WEST WILSON STREET
VILLA RICA, GA
ZIP 30180
Phone: (770) 456-4663
Fax: (770) 456-4661

The provider's authorized official is Colton Harold Blackmon .
The authorized official title is Owner and has the following contact phone number (770) 456-4663.

The CLIA number assigned to this NPI record is 11D2244881 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2011 and was last updated on 6/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyPHRE009763GEORGIANo
23336C0003XPharmacyCommunity/Retail PharmacyPHRE010412GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.