Organization
MEDICAP PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH GOSS (OWNER)
(706) 369-5822
Entity
Organization
Contact information
Practice address
824 HULL RD STE B, ATHENS, GA 30601-1534
(706) 369-5822
(706) 369-5825
Mailing address
824 HULL RD STE B, ATHENS, GA 30601-1534
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE009005
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1153965
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
09/11/2025
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