SOUTHERN CRESCENT PHARMACY INC
405 Carlton Rd
Palmetto, GA 30268
770-463-4031
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers - Pharmacy - | ||
Y | 3336C0003X | Suppliers - Pharmacy | GA | PHRE008980 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1126906 | OTHER | |
00247277A | GA | MEDICAID |