Individual
ERIC GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4797 S MAIN ST, ACWORTH, GA 30101-5339
(770) 974-3131
(770) 975-9735
Mailing address
4797 S MAIN ST, ACWORTH, GA 30101-5339
(770) 974-3131
(770) 975-9735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025473
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030357A
—
GA
01
—
1104152
NCPDP PROVIDER IDENTIFICATION NUMBER
GA
05
—
30019170A
—
GA
Enumeration date
03/07/2012
Last updated
03/07/2012
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