Organization
ALLSTATE PHARMACEUTICALS LLC
Active
Other names
AllState Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TED WILLIS (DIRECTOR)
(770) 978-7400
Entity
Organization
Contact information
Practice address
1940 PARKER CT, SUITE D, STONE MOUNTAIN, GA 30087-6400
(770) 978-7400
(770) 978-7402
Mailing address
1940 PARKER CT, SUITE D, STONE MOUNTAIN, GA 30087-6400
(770) 978-7400
(770) 978-7402
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009590
GA
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158927
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/18/2009
Last updated
01/05/2010
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