Organization
CONNECT CARE PHARMACY, LLC
Active
Other names
Connect Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUILLIANO FORTUNE PHARMD (OWNER/PIC)
(478) 654-5222
Entity
Organization
Contact information
Practice address
2191 HWY 247 CONNECTOR, BYRON, GA 31008-5531
(478) 654-5222
Mailing address
2191 GA HWY 247 CONNECTOR, BYRON, GA 31008-5531
(478) 654-5222
(478) 654-5209
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010782
GEORGIA PHARMACY LICENSE
GA
Enumeration date
10/02/2019
Last updated
10/17/2019
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