Organization
PRESBYTERIAN VILLAGE AUSTELL INC
Active
Other names
PRESBYTERIAN VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE HERITAGE PHARMD (DIR OF PHCY)
(770) 819-7001
Entity
Organization
Contact information
Practice address
2000 E WEST CONNECTOR, ATTN: PHARMACY, AUSTELL, GA 30106-1194
(770) 819-7001
(770) 819-7494
Mailing address
2000 E WEST CONNECTOR, ATTN: PHARMACY, AUSTELL, GA 30106-1194
(770) 819-7001
(770) 819-7494
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009068
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017513
PK
—
05
—
666876218A
—
GA
Enumeration date
03/08/2007
Last updated
12/08/2020
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