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Organization
CPM PHARMACY LLC
Active
Organization
CPM PHARMACY LLC
Active
Other names
Advanced Rx Pharmacy 034
Organization subpart
No
Provider details
NPI number
Authorized official
KATI GAINOUS (PHARMACY PROGRAM ADMINISTRATOR)
(925) 621-2900
Entity
Organization
Contact information
Practice address
3870 MEDICAL PARK DR, AUSTELL, GA 30106-1110
(678) 564-2233
(678) 401-4245
Mailing address
C/O ADVANCED RX MANAGEMENT, 4683 CHABOT DRIVE, SUITE 200, PLEASANTON, CA 94588
(925) 621-2909
(904) 389-1082
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009976
GA
Other
Enumeration date
12/26/2013
Last updated
06/11/2015
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