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Organization
PEACHTREE PHARMACY & MEDICAL SUPPLY, INC.
Active
Organization
PEACHTREE PHARMACY & MEDICAL SUPPLY, INC.
Active
Other names
Peachtree Pharmacy & Medical Supply, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL EKWEBELEM (PHARMACIST/CCEO)
(404) 488-4525
Entity
Organization
Contact information
Practice address
579 CONCORD RD SE STE 900, SMYRNA, GA 30082-2739
(770) 405-8664
(770) 405-8663
Mailing address
579 CONCORD RD SE STE 900, SMYRNA, GA 30082-2739
(770) 405-8664
(770) 405-8663
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009856
GA
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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