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Organization
PEACHTREE PHARMACY SERVICES
Active
Organization
PEACHTREE PHARMACY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES CHARLES HERNDON RPH (PHARMACY MANAGER)
(706) 865-0367
Entity
Organization
Contact information
Practice address
1018 SOUTH MAIN STR, HWY 129 SUITE A, CLEVELAND, GA 30528
(706) 865-0367
(706) 865-0931
Mailing address
1018 SOUTH MAIN STR, HWY 129 SUITE A, CLEVELAND, GA 30528
(706) 865-0367
(706) 865-0931
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
014565
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE009156
PHARMACY LIC NUM
GA
Enumeration date
06/01/2007
Last updated
11/06/2007
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