Organization
LIVING WELL PHARMACY #2 INC
Active
Other names
Living Well Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PHILLIP BRYANT (CFO)
(706) 422-9355
Entity
Organization
Contact information
Practice address
824 GI MADDOX PKWY, SUITE B, CHATSWORTH, GA 30705-2073
(706) 517-1901
(706) 517-2541
Mailing address
630 TI PI LN, CHATSWORTH, GA 30705-7786
(706) 517-1901
(706) 517-2541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHRE008958
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411552342A
—
GA
Enumeration date
08/23/2006
Last updated
06/17/2025
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