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Organization
REXTOX CONSULTANT LLC
Active
Organization
REXTOX CONSULTANT LLC
Active
Parent organization
RETOX HEALING HANDS PHARMACY
Other names
Retox Healing Hands Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
RETOX HEALING HANDS PHARMACY
Authorized official
RAPHAEL OGUNSUSI PHARMACY (OWNER)
(678) 478-9511
Entity
Organization
Contact information
Practice address
1810 HIGHWAY 20 SE STE 174, CONYERS, GA 30013-2001
(678) 478-9511
Mailing address
2630 WELLINGTON WAY SE, CONYERS, GA 30013-6413
(678) 478-9511
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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