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Contact Information

MORTAR & PESTLE, LLC
205 VERNON STREET
LAGRANGE, GA30240
 Phone: 706-298-4928
 Fax: 706-298-4929
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MORTAR & PESTLE, LLC

NPI # 1629418793
LBN Legal business name MORTAR & PESTLE, LLC
Authorized official JON MEEKS - (OWNER/PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 07/03/2013
Last updated 07/15/2020 - About 6 years ago
Identifiers
GA License # PHRE009938
GA Medicaid 003136178A
Other 2141011 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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