Organization
CAMP CREEK PHARMACY LLC
Active
Other names
Camp Creek Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA FARAH (OWNER/PHARMACIST)
(832) 818-8187
Entity
Organization
Contact information
Practice address
3886 PRINCETON LAKES WAY SW STE 180, ATLANTA, GA 30331-5511
(404) 494-8010
(404) 494-8025
Mailing address
PO BOX 5885, ATLANTA, GA 31107-0885
(404) 494-8010
(404) 494-8025
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009735
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1161152
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/10/2011
Last updated
04/20/2012
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