Organization
DUE WEST PHARMACY
Active
Other names
Due West Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MARQUESS (PHARM D)
(770) 456-5895
Entity
Organization
Contact information
Practice address
3880 DUE WEST RD NW STE 118, MARIETTA, GA 30064-1058
(770) 456-5895
(678) 540-6603
Mailing address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(678) 285-0760
(770) 971-0315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003139336A
—
GA
01
—
2176460
PK
—
Enumeration date
04/06/2018
Last updated
04/06/2018
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