Organization
GAINESVILLE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ITZELIS GODREAU (MANAGER)
(912) 332-2794
Entity
Organization
Contact information
Practice address
1079 JESSE JEWELL PKWY SW, GAINESVILLE, GA 30501-6103
(678) 971-1000
(678) 971-1031
Mailing address
3651 PEACHTREE PARKWAY SUITE E#422, SUWANEE, GA 30024
(404) 884-4588
(678) 971-1031
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
06/21/2019
Last updated
03/25/2020
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