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Organization
NORTHEAST GEORGIA MEDICAL CENTER, INC
Active
Organization
NORTHEAST GEORGIA MEDICAL CENTER, INC
Active
Other names
Northeast Georgia Medical Center Pharmacy-Braselton
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D STEINES (CFO)
(770) 219-3562
Entity
Organization
Contact information
Practice address
1515 RIVER PL STE 180, BRASELTON, GA 30517-5603
(770) 848-6337
(770) 848-6338
Mailing address
PO BOX 741891, ATLANTA, GA 30374-1891
(770) 848-6337
(770) 848-6338
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010289
GA
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
04/13/2016
Last updated
04/22/2020
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