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Organization

LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.

Active
Parent organization
LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.
Other names
AvitaCare
Organization subpart
Yes

Provider details

NPI number
Legal business name
LONG'S DRUGS OF SANDERSVILLE, GEORGIA, INC.
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(704) 641-7967
Entity
Organization

Contact information

Practice address
2140 PEACHTREE RD NW STE 232, ATLANTA, GA 30309-1316
(404) 231-4431
Mailing address
5700 GRANITE PKWY STE 425, PLANO, TX 75024-6648

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207RI0200X
Infectious Disease Physician
Primary
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
09/20/2022
Last updated
09/20/2022
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