Organization
PRIDE MEDICAL INC
Active
Other names
PRIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON NASH PHARMD (DIRECTOR OF PHARMACY)
(404) 355-3788
Entity
Organization
Contact information
Practice address
3280 HOWELL MILL RD NW, SUITE 326, ATLANTA, GA 30327-4111
(404) 355-3788
(678) 244-2157
Mailing address
3280 HOWELL MILL RD NW, SUITE 326, ATLANTA, GA 30327-4111
(404) 355-3788
(678) 244-2157
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007491
GA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1141136
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
759295303A
—
GA
Enumeration date
09/12/2006
Last updated
12/18/2013
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