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

Mirror Lake Drugs & Medical Services LLC

Organization Pharmacist · NPI 1962755256

Mirror Lake Drugs & Medical Services LLC is a Pharmacist in Villa Rica, Georgia. Licensed in Georgia. Registered with an NPI since 2012.

Licensed in
GA
In the registry since
2012
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

895 Dallas Hwy
Villa Rica, GA 30180-1237
Phone: (770) 462-1152
Fax: (770) 462-1154
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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 PHRE009876 (GA)
Pharmacist Taxonomy 183500000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1962755256
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chymar Ihekwereme — Pic/Chief Executive Officer · (770) 462-1152
Other names Rockmart Pharmacy & Medical Services Llc
NPI enumeratedOctober 24, 2012
Last updated in NPPESOctober 22, 2020
Certification dateOctober 22, 2020
Mailing address895 Dallas Hwy, Villa Rica, GA 30180-1237

Other providers in Villa Rica