Healthcare Provider Details

I. General information

NPI: 1700701620
Provider Name (Legal Business Name): ALLMOND & WHIPPLE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 MEADOWS LN
VIDALIA GA
30474-8913
US

IV. Provider business mailing address

1704 MEADOWS LN
VIDALIA GA
30474-8913
US

V. Phone/Fax

Practice location:
  • Phone: 912-537-4147
  • Fax: 912-537-1914
Mailing address:
  • Phone: 912-537-4147
  • Fax: 912-537-1914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN ROLAND BLACK
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 912-537-4147