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Organization
NORTHSIDE DRUGS, INC.
Active
Organization
NORTHSIDE DRUGS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN GRIZZARD (PHARMACIST/OWNER)
(706) 648-2181
Entity
Organization
Contact information
Practice address
1109 HIGHWAY 19 N, THOMASTON, GA 30286-2207
(706) 648-2181
(706) 648-6430
Mailing address
1109 HIGHWAY 19 N, THOMASTON, GA 30286-2207
(706) 648-6430
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008873
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00032678B4
—
GA
Enumeration date
09/22/2006
Last updated
03/23/2011
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