Organization
SPECIALTY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT RAVAL (PRESIDENT)
(770) 496-8998
Entity
Organization
Contact information
Practice address
4229 1ST AVE STE B, TUCKER, GA 30084-4469
(770) 496-8998
Mailing address
4229 1ST AVE STE B, TUCKER, GA 30084-4469
(770) 496-8998
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010292
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003176651A
—
GA
Enumeration date
05/24/2016
Last updated
07/13/2016
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