# NORTH GEORGIA COMPOUNDING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699923557
- **Authorized official:** DAVID JASON RICH RPH (PRESIDENT)
- **Authorized official phone:** (770) 479-5330

## Contact information

- **Practice address:** 220 RIVERSTONE DR, CANTON, GA 30114-5256
- **Practice address phone:** (770) 479-5330
- **Mailing address:** 220 RIVERSTONE DR, CANTON, GA 30114-5256
- **Mailing address phone:** (770) 479-5330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE008833 | GA | Yes |

## Other

- **Enumeration date:** 09/04/2008
- **Last updated:** 09/04/2008