Organization
SSC AFFILIATES INC
Active
Other names
Shepherd Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER PAUL MCGOURK PHARMD (MANAGER)
(404) 350-7743
Entity
Organization
Contact information
Practice address
2020 PEACHTREE RD NW, ATLANTA, GA 30309-1426
(404) 350-7743
(404) 350-7514
Mailing address
2020 PEACHTREE RD NW, ATLANTA, GA 30309-1426
(404) 350-7743
(404) 350-7514
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE005987
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE005987
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000248069C
—
GA
05
—
000498154A
—
GA
Enumeration date
08/30/2006
Last updated
02/22/2017
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