# CPM PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Rx Pharmacy 034
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790106458
- **Authorized official:** KATI GAINOUS (PHARMACY PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (925) 621-2900

## Contact information

- **Practice address:** 3870 MEDICAL PARK DR, AUSTELL, GA 30106-1110
- **Practice address phone:** (678) 564-2233
- **Practice address fax:** (678) 401-4245
- **Mailing address:** C/O ADVANCED RX MANAGEMENT, 4683 CHABOT DRIVE, SUITE 200, PLEASANTON, CA 94588
- **Mailing address phone:** (925) 621-2909
- **Mailing address fax:** (904) 389-1082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009976 | GA | Yes |

## Other

- **Enumeration date:** 12/26/2013
- **Last updated:** 06/11/2015