# RIVERSIDE DISCOUNT PHARMACY

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

## Provider details

- **NPI number:** 1881751154
- **Authorized official:** CHRISTOPHER MUOMAH (PRESIDENT)
- **Authorized official phone:** (770) 732-9342

## Contact information

- **Practice address:** 705 S GORDON RD, STE A, MABLETON, GA 30126
- **Practice address phone:** (770) 732-9342
- **Practice address fax:** (770) 732-9347
- **Mailing address:** 705 S GORDON RD, STE A, MABLETON, GA 30126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 007401 | GA | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 09/12/2007