Organization
TERESE INC.
Active
Other names
Peach Orchard Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
TERESE K FORDHAM (OWNER)
(706) 798-3253
Entity
Organization
Contact information
Practice address
2529 PEACH ORCHARD RD, AUGUSTA, GA 30906-2412
(706) 798-3253
(706) 798-3225
Mailing address
2529 PEACH ORCHARD RD, AUGUSTA, GA 30906-2412
(706) 798-3253
(706) 798-3225
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
RPH09972
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787783075A
—
GA
Enumeration date
10/12/2016
Last updated
10/12/2016
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