Organization
NORTH GEORGIA COMPOUNDING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JASON RICH RPH (PRESIDENT)
(770) 479-5330
Entity
Organization
Contact information
Practice address
220 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 479-5330
Mailing address
220 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 479-5330
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008833
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1152052
NABP
GA
Enumeration date
09/04/2008
Last updated
09/04/2008
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