Organization
JOHNSONS HOMETOWN PHARMACY INC
Active
Other names
Johnson's River Place Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JOHNSON (PRESIDENT/OWNER)
(770) 315-4103
Entity
Organization
Contact information
Practice address
2625 OLD WINDER HWY STE H, BRASELTON, GA 30517-7021
(770) 967-1000
(770) 967-1080
Mailing address
2625 OLD WINDER HWY, SUITE H, BRASELTON, GA 30517-7020
(770) 967-1000
(770) 967-1080
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009726
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109653A
—
GA
01
—
2128713
PK
—
Enumeration date
02/08/2011
Last updated
03/16/2016
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