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General NPI Number Information
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NPI Number | 1417914102
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Entity Type | Organization
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Legal Business Name | MORRIS DRUG CO INC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 646 MAIN ST N
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City | PEARSON
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State | GA
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Zip | 31642-7549
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Country | US
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Telephone | 912-422-3631
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Fax | 912-422-6104
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Provider Business Mailing Address
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Address Line | PO BOX 608
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City | PEARSON
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State | GA
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Zip | 31642-0608
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Country | US
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Telephone | 912-422-3631
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Fax | 912-422-6104
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW TANNER
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Credential | PHARMD
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Telephone | 912-422-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE005930
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License Number State | GA
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