# PRESBYTERIAN VILLAGE AUSTELL 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:** PRESBYTERIAN VILLAGE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396876793
- **Authorized official:** DEBBIE HERITAGE PHARMD (DIR OF PHCY)
- **Authorized official phone:** (770) 819-7001

## Contact information

- **Practice address:** 2000 E WEST CONNECTOR, ATTN: PHARMACY, AUSTELL, GA 30106-1194
- **Practice address phone:** (770) 819-7001
- **Practice address fax:** (770) 819-7494
- **Mailing address:** 2000 E WEST CONNECTOR, ATTN: PHARMACY, AUSTELL, GA 30106-1194
- **Mailing address phone:** (770) 819-7001
- **Mailing address fax:** (770) 819-7494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHRE009068 | GA | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 12/08/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2017513 | PK | — |
| 05 | — | 666876218A | — | GA |