Organization
DECATUR APOTHECARY
Active
Other names
THE MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
RAMIRO CEPERO PHD (OWNER)
(770) 813-8083
Entity
Organization
Contact information
Practice address
3055 SAINT ANDREWS DR, DULUTH, GA 30096-3584
(770) 813-8083
(770) 813-9365
Mailing address
3055 SAINT ANDREWS DR, DULUTH, GA 30096-3584
(770) 813-8083
(770) 813-9365
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
007765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00820168
—
GA
01
—
1128051
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
08/30/2011
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