Organization
HAWTHORNE COMPOUNDING PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRES ARTHUR ULLRICH RPH (OWNER)
(706) 521-0272
Entity
Organization
Contact information
Practice address
100 HAWTHORNE LN STE A, ATHENS, GA 30606-2171
(706) 521-0272
(706) 521-0273
Mailing address
100 HAWTHORNE LN STE A, ATHENS, GA 30606-2171
(706) 521-0272
(706) 521-0273
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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