Organization
GLORY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY AFON MSC PHARM MBA (PHARMACY MGR)
(770) 934-5252
Entity
Organization
Contact information
Practice address
1462 MONTREAL RD, TUCKER, GA 30084-6904
(770) 934-5252
(770) 934-5959
Mailing address
1462 MONTREAL RD, TUCKER, GA 30084-6904
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHRE008996
GA
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1153903
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/22/2006
Last updated
09/11/2025
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