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General NPI Number Information
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NPI Number | 1780738245
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Entity Type | Organization
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Legal Business Name | SILVER CREEK RX LLC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 4450 ROCKMART RD SE
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City | SILVER CREEK
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State | GA
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Zip | 30173-2438
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Country | US
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Telephone | 706-292-0106
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Fax | 706-292-0647
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Provider Business Mailing Address
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Address Line | PO BOX 230
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City | SILVER CREEK
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State | GA
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Zip | 30173-2438
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Country | US
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Telephone | 706-292-0106
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Fax | 706-292-0647
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Authorized Official
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Title or Position | OWNER
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Name | LISA CORNETT HARRIS
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Credential | RPH
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Telephone | 706-292-0106
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE010266
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License Number State | GA
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