Organization
JOVANS PHARMACY CORP
Active
Other names
JOVANS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LINDO (CEO)
(678) 481-3651
Entity
Organization
Contact information
Practice address
6001 HIGHWAY 42, REX, GA 30273-1030
(770) 968-5800
(770) 968-5855
Mailing address
6001 HIGHWAY 42, REX, GA 30273-1030
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009028
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154361
OTHER ID NUMBER
—
Enumeration date
05/23/2006
Last updated
06/06/2008
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