# LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.
- **Other names:** Avita Pharmacy 1046
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437871506
- **Legal business name:** LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.
- **Authorized official:** ASHLEY ELLIS (CORPORATE COUNSEL)
- **Authorized official phone:** (704) 641-7967

## Contact information

- **Practice address:** 2140 PEACHTREE RD NW STE 232, ATLANTA, GA 30309-1316
- **Practice address phone:** (404) 231-4431
- **Mailing address:** 5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648

## Taxonomy

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

## Other

- **Enumeration date:** 09/15/2022
- **Last updated:** 09/15/2022