Organization
ROCKY TOP PHARMACY INC
Active
Other names
LONGLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY GRIMMITT RPH (PRESIDENT)
(706) 866-1220
Entity
Organization
Contact information
Practice address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1404
(706) 866-1220
(706) 861-7505
Mailing address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1404
(706) 866-1220
(706) 861-7505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007220
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00438017A
—
GA
01
—
2012939
PK
—
Enumeration date
11/17/2006
Last updated
04/20/2016
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