Organization
REVUE PHARMACY
Active
Other names
ReVue Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GICHUKI KIMANI PHARM.D. (PHARMACY MANAGER)
(404) 512-0517
Entity
Organization
Contact information
Practice address
869 N MAIN ST STE 203, ALPHARETTA, GA 30009-8372
(470) 275-6795
(470) 275-4962
Mailing address
869 N MAIN ST STE 203, ALPHARETTA, GA 30009-8372
(702) 756-7954
(470) 275-4962
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHRE010712
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
02/28/2019
Last updated
02/28/2019
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