Mimbs Drug Co Dba Dixie City Pharmacy # 2
Organization Active NPI Pharmacy · Oakwood, GA
NPI 1467439760 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1467439760
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PHRE006004 (GA)
- Legal business name
- MIMBS DRUG CO DBA DIXIE CITY PHARMACY # 2
- Practice address
- 4222 McEver Rd
Oakwood, GA 30566-2237 - Phone
- (770) 536-1099
- Fax
- (770) 536-0577
- NPI assigned
- Dec 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Eddie H Mimbs, RPH
- Title
- President
- Phone
- (770) 536-3329
Corporate family (same tax ID) 5
Practitioners 2
National Provider Directory
- Tax ID family
- Dixie City Pharmacy 1
Locations
4222 McEver Rd
Oakwood, GA 30566
Phone (770) 536-1099
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHRE006004 | GA | Yes |
Addresses
Primary practice location
4222 McEver Rd
Oakwood, GA 30566-2237
Mailing address
4222 McEver Rd
Oakwood, GA 30566-2237
Phone (770) 536-1099
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1126867 | Other | GA | NCPDP NUMBER |
| PHRE006004 | Other | GA | STATE LISC # |
| 00247937A | Medicaid | GA |
Other names
- Dixie City Pharmacy # 2
Other providers in Oakwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.