Organization
DEKALB COMMUNITY SERVICE BOARD
Active
Other names
North DeKalb MHC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY S RICHEY MBA (DIRECTOR)
(404) 294-3836
Entity
Organization
Contact information
Practice address
3807 CLAIRMONT RD, CHAMBLEE, GA 30341-4911
(770) 457-6236
Mailing address
3807 CLAIRMONT RD, CHAMBLEE, GA 30341-4911
(770) 457-6236
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
007051
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00058858A
—
GA
01
—
1136654
NCPDP/NABP PROVIDER NUMBE
GA
Enumeration date
07/26/2005
Last updated
08/22/2020
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