Organization
YETOLA INC
Active
Other names
PEACHVIEW DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
YETUNDE EZEANII (CEO)
(678) 581-1223
Entity
Organization
Contact information
Practice address
525 FRANKLIN GTWY SE, MARIETTA, GA 30067-7707
(678) 581-1223
(678) 581-2356
Mailing address
525 FRANKLIN GTWY SE, MARIETTA, GA 30067-7707
(678) 581-1223
(678) 581-2356
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
PHRE008552
GA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00925097A
—
GA
01
—
2014409
PK
—
Enumeration date
08/10/2006
Last updated
03/21/2024
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