Organization
BAAS & J INC
Active
Other names
Treasure Pharmacy and Store
Organization subpart
No
Provider details
NPI number
Authorized official
BLESSING UDEH (OWNER)
(770) 672-6913
Entity
Organization
Contact information
Practice address
3753 AUSTELL RD STE 130, AUSTELL, GA 30106-6829
(770) 672-6913
(770) 693-8043
Mailing address
PO BOX 516, DALLAS, GA 30132-0009
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009857
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127765A
—
GA
01
—
1162558
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/06/2012
Last updated
10/19/2012
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