Organization
BVRX INC
Active
Other names
DALTON DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BRYANT (CFO)
(706) 260-7998
Entity
Organization
Contact information
Practice address
2705 AIRPORT RD STE 102, DALTON, GA 30721-9200
(706) 529-4646
Mailing address
824 GI MADDOX PKWY, CHATSWORTH, GA 30705-2147
(706) 517-1901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009768
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1161633
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/21/2011
Last updated
08/15/2011
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