Organization
NORTH HEIGHTS PHARMACY INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRADY C TATE RPH (OWNER/PHARMACIST)
(706) 295-5712
Entity
Organization
Contact information
Practice address
411 W 10TH ST NE, ROME, GA 30165-2640
(706) 295-5712
(706) 295-3497
Mailing address
411 W 10TH ST NE, ROME, GA 30165-2640
(706) 295-5712
(706) 295-3497
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PHRE006126
GA
3336L0003X
Long Term Care Pharmacy
Primary
PHRE006126
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000032656A
—
GA
01
—
1113454
NCPDP #
GA
Enumeration date
07/03/2006
Last updated
03/07/2023
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