Organization
ADAIRSVILLE WORX LLC
Active
Other names
Adairsville Drug
Organization subpart
No
Provider details
NPI number
Authorized official
GREG BOHANNON (SHAREHOLDER)
(423) 396-6963
Entity
Organization
Contact information
Practice address
6000 JOE FRANK HARRIS PKWY NW, SUITE F, ADAIRSVILLE, GA 30103-2443
(770) 773-3521
(770) 773-9882
Mailing address
6000 JOE FRANK HARRIS PKWY NW, SUITE F, ADAIRSVILLE, GA 30103-2443
(770) 773-3521
(770) 773-9882
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137336A
—
GA
05
—
003137915A
—
GA
01
—
2141766
PK
—
Enumeration date
08/12/2013
Last updated
06/12/2020
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