Healthcare Provider Details

I. General information

NPI: 1952661399
Provider Name (Legal Business Name): VILLAGE APOTHECARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 RIVER RD BLDG 2
COLUMBUS GA
31904-3352
US

IV. Provider business mailing address

6801 RIVER RD STE 201
COLUMBUS GA
31904-3300
US

V. Phone/Fax

Practice location:
  • Phone: 706-327-4242
  • Fax: 706-327-4296
Mailing address:
  • Phone: 706-327-4242
  • Fax: 706-327-4296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE009835
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GEORGE KELLY
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 706-327-4242