Organization
WOODSTOCK PHARMACEUTICAL & COMPOUNDING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN GRIFFIN MARQUESS PHARMD, CDE,CDM (PRESIDENT)
(770) 926-6478
Entity
Organization
Contact information
Practice address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(770) 926-6478
(770) 531-7557
Mailing address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(770) 926-6478
(770) 531-7557
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007695
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000178373A
—
GA
Enumeration date
11/09/2006
Last updated
12/10/2012
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