# MEDSTORE INC

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

## Provider details

- **NPI number:** 1811700677
- **Authorized official:** NEHEMIAH TRAVIS HARVARD (CEO)
- **Authorized official phone:** (404) 333-2968

## Contact information

- **Practice address:** 217 DAVIS RD STE C, AUGUSTA, GA 30907-0954
- **Practice address phone:** (404) 333-2968
- **Mailing address:** 1940 LAKEWOOD TER SE, ATLANTA, GA 30315-6669
- **Mailing address phone:** (818) 791-6725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/27/2025
- **Last updated:** 01/27/2025