Organization
TRANS ALLIANCE LAB INC
Active
Other names
wayfield pharmacy 1801
Organization subpart
No
Provider details
NPI number
Authorized official
CHINWE NWABUDE (PHARMACIST)
(404) 699-9000
Entity
Organization
Contact information
Practice address
2020 HEADLAND DR, EAST POINT, GA 30344-2135
(404) 530-0000
(404) 530-0055
Mailing address
PO BOX 767757, ROSWELL, GA 30076-7757
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE009574
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1158511
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/25/2009
Last updated
04/29/2009
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