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Organization
CARROLLTON ORTHOPAEDIC CLINIC PC
Active
Organization
CARROLLTON ORTHOPAEDIC CLINIC PC
Active
Other names
Carrollton Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GILBERT (CFO)
(727) 755-0693
Entity
Organization
Contact information
Practice address
204 ALLEN MEMORIAL DR STE 102, BREMEN, GA 30110-2063
(727) 755-0679
Mailing address
311 PARK PLACE BLVD, SUITE 500, CLEARWATER, FL 33759-4904
(727) 755-0693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
038964
GA
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000104427
—
GA
01
—
2158424
PK
—
Enumeration date
02/15/2016
Last updated
03/03/2016
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