Organization
EAST MARIETTA DRUG CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMALA SMITH MARQUESS PHARMD (SECRETARY)
(770) 973-7600
Entity
Organization
Contact information
Practice address
1480 ROSWELL RD, MARIETTA, GA 30062-3670
(770) 973-7600
(770) 973-3032
Mailing address
1480 ROSWELL RD, MARIETTA, GA 30062-3670
(770) 973-7600
(770) 973-3032
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
0831400001
GA
333600000X
Pharmacy
Primary
1112072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00026342A
—
GA
05
—
00026342B
—
GA
01
—
1112072
NABP
GA
Enumeration date
06/01/2005
Last updated
08/17/2012
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