# WAUKA MOUNTAIN PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WAUKA MOUNTAIN PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205982352
- **Authorized official:** SHWETA WOODSMALL PHARMD (OWNER / PHARMACIST)
- **Authorized official phone:** (770) 983-9556

## Contact information

- **Practice address:** 5233 CLEVELAND HWY, CLERMONT, GA 30527-2205
- **Practice address phone:** (770) 983-9556
- **Practice address fax:** (770) 983-9580
- **Mailing address:** PO BOX 410, CLERMONT, GA 30527-0410
- **Mailing address phone:** (770) 983-9556
- **Mailing address fax:** (770) 983-9580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE006914 | GA | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 06/18/2019