Organization
PANACEA PHARMACY AND WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOUR ISSA RPH (PRESIDENT)
(404) 602-0024
Entity
Organization
Contact information
Practice address
225 PEACHTREE ST NE, SUITE B13, ATLANTA, GA 30303-1701
(404) 602-0024
(404) 602-0017
Mailing address
225 PEACHTREE ST NE, SUITE B13, ATLANTA, GA 30303-1701
(404) 602-0024
(404) 602-0017
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE009701
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE009701
PHARMACY STATE LICENSE
GA
Enumeration date
10/14/2010
Last updated
10/14/2010
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