Tallapoosa Rx LLC
NPI #1013575604 in Tallapoosa, Georgia
Provider Information
- NPI Number
- 1013575604
- Entity Type
- Organization
- Organization Name
- Tallapoosa Rx LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 30, 2019
- Last Updated
- Dec 21, 2020
Practice Location
- Address
- 2066 US HIGHWAY 78
- City
- Tallapoosa
- State
- Georgia
- ZIP Code
- 30176-1368
- Phone
- (770) 574-2339
Authorized Official
- Name
- JACOB MOUCHET, PHARM D
- Title
- OWNER
- Phone
- (770) 574-2339
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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