Camp Creek Village Pharmacy INC.
Pharmacy, Community/Retail Pharmacy in Atlanta, GA. Organization (NPI-2).
Details
- NPI
- 1881024479
- Entity type
- Organization (NPI-2)
- Legal business name
- Camp Creek Village Pharmacy INC.
- Organization subpart
- No
- Enumeration date
- Nov 18, 2013
- Last updated
- Nov 18, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PHRE009971 | GA | Yes |
Other names
- Butner Village Pharmacy (Doing Business As)
Practice location
3220 Butner Rd Sw Suite #130Atlanta, GA 30331
Phone 404-228-0238 · Fax 404-500-4111
Mailing address
400 Rexham Way SwAtlanta, GA 30331-7994
Phone 404-228-0238 · Fax 404-500-4111
Authorized official
Kenwin C.H. Morris
Owner
4042280238
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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