Organization
LONGS DRUGS OF SANDERSVILLE GEORGIA INC
Active
Other names
Longs Dekalb Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL FROST (DIRECTOR, BUS DEV/OWNER)
(404) 583-6945
Entity
Organization
Contact information
Practice address
1428 SCOTT BLVD, DECATUR, GA 30030-1424
(404) 270-9242
(404) 270-9273
Mailing address
PO BOX 603111, CHARLOTTE, NC 28260-3111
(803) 254-5884
(866) 717-0781
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149183
PK
—
Enumeration date
05/04/2010
Last updated
12/18/2015
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