# TAJENDRA PRASAD PHARM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peach Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861314643
- **Authorized official:** MALAY PATEL PHARMD (OWNER/PIC)
- **Authorized official phone:** (478) 538-2788

## Contact information

- **Practice address:** 1818 HOUSTON LAKE RD UNIT B600, PERRY, GA 31069-2684
- **Practice address phone:** (478) 538-2788
- **Mailing address:** 12003 WATSON BLVD, BYRON, GA 31008-5577
- **Mailing address phone:** (478) 538-2788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/27/2026
- **Last updated:** 07/27/2026