Organization
PRESTIGE PHARMACY SNELLVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMI PATEL (MANAGING MEMBER)
(678) 315-1516
Entity
Organization
Contact information
Practice address
1551 JANMAR RD, SUITE B, SNELLVILLE, GA 30078-5606
(470) 735-4700
(470) 395-9048
Mailing address
1551 JANMAR RD, SUITE B, SNELLVILLE, GA 30078-5606
(470) 735-4700
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010324
GA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167400
PK
—
Enumeration date
11/28/2016
Last updated
03/27/2017
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