Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crystal Pharmacy LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1790877942

Crystal Pharmacy LLC is a Durable Medical Equipment & Medical Supplies in Moultrie, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

705 S Main St
Moultrie, GA 31768-5432
Phone: (229) 985-4137
Fax: (229) 890-5968
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence PHRE002206 (GA)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1790877942
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scotty Jarvis — Managing Member · (229) 985-4137
Other names Crystal Pharmacy
NPI enumeratedSeptember 28, 2006
Last updated in NPPESNovember 25, 2014
Mailing addressPo Box 8, Moultrie, GA 31776-0008

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