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Organization
PANACEA PHARMACY AND WELLNESS CENTER INC
Active
Organization
PANACEA PHARMACY AND WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOUR ISSA RPH (PRESIDENT)
(404) 602-0024
Entity
Organization
Contact information
Practice address
225 PEACHTREE ST NE, SUITE B13, ATLANTA, GA 30303-1701
(404) 602-0024
(404) 602-0017
Mailing address
225 PEACHTREE ST NE, SUITE B13, ATLANTA, GA 30303-1701
(404) 602-0024
(404) 602-0017
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE009701
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE009701
PHARMACY STATE LICENSE
GA
Enumeration date
10/14/2010
Last updated
10/14/2010
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