Organization
AUSTELL PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA KIGER RPH (PHARMACIST IN CHARGE)
(770) 726-2970
Entity
Organization
Contact information
Practice address
3802 AUSTELL RD SW, MARIETTA, GA 30008-5863
(770) 726-2970
(770) 693-2375
Mailing address
3802 AUSTELL RD SW, MARIETTA, GA 30008-5863
(770) 726-2970
(770) 693-2375
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010747
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
07/16/2019
Last updated
07/16/2019
Update your record
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