Organization
ROSSVILLE WORX LLC
Active
Other names
LONGLEY'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG ODELL BOHANNON (PRESIDENT)
(423) 309-1517
Entity
Organization
Contact information
Practice address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1404
(706) 866-1220
Mailing address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1404
(706) 866-1220
(706) 861-7505
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003200177A
—
GA
05
—
Q032764
—
TN
Enumeration date
06/12/2017
Last updated
05/16/2025
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