Organization
SANDSRX GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHDI AL HALLAQ (COO)
(502) 802-0245
Entity
Organization
Contact information
Practice address
1586 MARKET PLACE BLVD, CUMMING, GA 30041-7926
(770) 744-5588
(888) 388-1309
Mailing address
1586 MARKET PLACE BLVD, CUMMING, GA 30041-7926
(770) 744-5588
(888) 388-1309
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/21/2023
Last updated
12/07/2023
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