Organization
COWAN PHARMACY LLC
Active
Other names
Conyers Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE FAIRCHILD (SECRETARY)
(770) 929-1414
Entity
Organization
Contact information
Practice address
1179 WEST AVE SW, CONYERS, GA 30012-5280
(770) 929-1414
Mailing address
1179 WEST AVE SW, CONYERS, GA 30012-5280
(770) 929-1414
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010400
GA
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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