Organization · Type 2 NPI

Mirror Lake Drugs & Medical Services LLC

Community/Retail Pharmacy · Villa Rica, GA

NPI number 1689272452 Active

Practice location

895 Dallas Hwy
Villa Rica, GA 30180-1237

Fax (770) 462-1154

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Another provider at this address

Mirror Lake Drugs & Medical Services LLCCommunity/Retail Pharmacy Villa Rica, GA NPI 1962755256

Other community/retail pharmacy providers in Villa Rica

See all in Villa Rica →

NPI record

NPI: 1689272452
Entity type: Organization (Type 2)
Issued: Oct 14, 2020
Last updated: Mar 27, 2026
Status: Active

Other names

<unavail>
Mirror Lake Drugs · doing business as
Rockmart Pharmacy & Medical Services LLC · former legal business name
Rockmart Pharmacy & Medical Services LLC · former legal business name

Authorized official

Mr. Chymar Okorie Ihekwereme, RPH
Pharmacist/ Chief Executive Officer
(770) 462-1152

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1689272452

Mirror Lake Drugs & Medical Services LLC's National Provider Identifier is 1689272452, issued on Oct 14, 2020. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Villa Rica, GA. The record was last updated on Mar 27, 2026.