# KENNESTONE HOSPITAL, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** WellStar Pharmacy Network
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386943009
- **Authorized official:** EBENEZER ERZUAH (EXEC DIRECTOR REIMBURSEMENT)
- **Authorized official phone:** (470) 956-4981

## Contact information

- **Practice address:** 3950 AUSTELL RD, SUITE 8, AUSTELL, GA 30106-1121
- **Practice address phone:** (470) 732-2111
- **Practice address fax:** (678) 495-8798
- **Mailing address:** PO BOX 741705, ATLANTA, GA 30374-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/21/2011
- **Last updated:** 05/06/2020