Organization
RIVERSTONE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY LYNN PETRAROLI RPH (PHARMACIST IN CHARGE)
(706) 258-2294
Entity
Organization
Contact information
Practice address
101 RIVERSTONE VIS, SUITE 100, BLUE RIDGE, GA 30513-6648
(706) 258-2294
(706) 258-4149
Mailing address
101 RIVERSTONE VIS, SUITE 100, BLUE RIDGE, GA 30513-6648
(706) 258-2294
(706) 258-4149
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE008584
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00942719A
—
GA
01
—
1149500
NABP
—
Enumeration date
03/15/2006
Last updated
03/07/2023
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