VILLA RICA RX LLC
NPI 1073300497
Pharmacy - Long Term Care Pharmacy in Villa Rica, GA

Active since April 21, 2025CLIA 11D2244881 · Waiver
222 W WILSON ST, VILLA RICA, GA 30180(770) 456-4663 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Villa Rica Rx Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VILLA RICA RX LLC (NPI 1073300497), doing business as Villa Rica Drugs Ltc, is a healthcare organization registered as a long term care pharmacy in Villa Rica, Georgia and active in the NPI registry since April 2025. The organization holds a CLIA Waiver certificate valid through December 6, 2027 and lists Colton Blackmon, Owner, as its authorized official.

NPPES Registry Identity

NPI1073300497
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameVILLA RICA RX LLC
Location Address222 W WILSON STVilla Rica, GA 30180-1807
Mailing Address222 W Wilson StVilla Rica, GA 30180-1807 · (770) 456-4663
Organization SubpartNo
Authorized OfficialColton BlackmonOwner · (770) 456-4663
Enumeration DateApril 21, 2025
NPPES CertifiedApril 16, 2025
NPI 1073300497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

222 W WILSON ST, Villa Rica, GA 30180

Other Names 1

Doing Business AsVilla Rica Drugs Ltc

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2244881

Villa Rica Drugs · Villa Rica, GA
Active · expires Dec 6, 2027
CLIA Number11D2244881
Laboratory TypePharmacy
Certificate Effective DateDecember 7, 2025
Certificate Expiration DateDecember 6, 2027
Laboratory DirectorColton Blackmon
Laboratory Phone(770) 456-4663
Laboratory LocationVilla Rica Drugs222 West Wilson Street, Villa Rica, GA 30180
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Villa Rica Rx LLC's NPI number?

The NPI number for Villa Rica Rx LLC is 1073300497. It was assigned to this organization in the NPPES registry on April 21, 2025. The provider is doing business as Villa Rica Drugs LTC.

Where is Villa Rica Rx LLC located?

Villa Rica Rx LLC is located at 222 W Wilson St, Villa Rica, GA 30180. The listed phone number is (770) 456-4663.

What is Villa Rica Rx LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Villa Rica Rx LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2244881) is associated with this NPI, valid through December 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Villa Rica Rx LLC accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Baylor Scott and White Health Plan, Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield of Wyoming and 9 other insurers list Villa Rica Rx LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Villa Rica Rx LLC was last updated on April 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.