# RIVERSIDE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** RIVERSIDE PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336218288
- **Authorized official:** SCOTTIE BARTON (OWNER)
- **Authorized official phone:** (770) 532-6253

## Contact information

- **Practice address:** 935 GREEN ST NW, GAINESVILLE, GA 30501-3325
- **Practice address phone:** (770) 532-6203
- **Practice address fax:** (770) 532-3692
- **Mailing address:** 935 GREEN ST NW, GAINESVILLE, GA 30501-3325
- **Mailing address phone:** (770) 532-6203
- **Mailing address fax:** (770) 532-3692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE006669 | GA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 09/01/2016