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General NPI Number Information
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NPI Number | 1518823640
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Entity Type | Organization
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Legal Business Name | SOUTHERN SHORES PHARMACY, LLC
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 2658 US HIGHWAY 17
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3374
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Country | US
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Telephone | 912-356-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 2658 US HIGHWAY 17
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3374
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Country | US
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Telephone | 912-356-9900
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KELLY LOWERTS DICK
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Credential | PHARM. D.
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Telephone | 912-356-9900
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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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