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Organization
TAJENDRA PRASAD PHARM LLC
Active
Organization
TAJENDRA PRASAD PHARM LLC
Active
Other names
Peach Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MALAY PATEL PHARMD (OWNER/PIC)
(478) 538-2788
Entity
Organization
Contact information
Practice address
1818 HOUSTON LAKE RD UNIT B600, PERRY, GA 31069-2684
(478) 538-2788
Mailing address
12003 WATSON BLVD, BYRON, GA 31008-5577
(478) 538-2788
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
07/27/2026
Last updated
07/27/2026
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