Organization
HARVILLE GROUP, LLC
Active
Other names
ATLANTA PHARMACY & MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT HARVILLE (MGR)
(770) 672-7976
Entity
Organization
Contact information
Practice address
1395 S MARIETTA PKWY SE BLDG 400-105, MARIETTA, GA 30067-4438
(770) 672-7976
(770) 672-7975
Mailing address
1395 S MARIETTA PKWY SE, BLDG 400-105, MARIETTA, GA 30067-4440
(770) 672-7976
(770) 672-7975
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHHH000051
GA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1162382
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/09/2012
Last updated
05/09/2012
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