# PAVILION COMPOUNDING PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PAVILION COMPOUNDING PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801926878
- **Authorized official:** BRAD CHERSON RPH (OWNER/MANAGER)
- **Authorized official phone:** (404) 350-5780

## Contact information

- **Practice address:** 3193 HOWELL MILL RD NW, STE 122A, ATLANTA, GA 30327-2119
- **Practice address phone:** (404) 350-5780
- **Practice address fax:** (404) 350-5640
- **Mailing address:** 3193 HOWELL MILL RD NW, STE 122A, ATLANTA, GA 30327-2119
- **Mailing address phone:** (404) 350-5780
- **Mailing address fax:** (404) 350-5640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE006901 | GA | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 03/20/2014