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Organization
EAST MARIETTA DRUG COMPANY, INC
Active
Organization
EAST MARIETTA DRUG COMPANY, INC
Active
Other names
East Marietta Drug Company, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MARQUESS (OWNER)
(770) 973-7600
Entity
Organization
Contact information
Practice address
1480 ROSWELL RD, MARIETTA, GA 30062-3670
(770) 973-7600
(770) 973-3032
Mailing address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(678) 285-0760
(770) 971-0315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PHRE007888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000026342A
—
GA
01
—
2176495
PK
—
Enumeration date
04/06/2018
Last updated
04/06/2018
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