Organization
ATHENS MEDICAL ARTS PHARMACY INC
Active
Other names
HAWTHORNE DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON ULLRICH (MANAGER)
(706) 548-5227
Entity
Organization
Contact information
Practice address
975 HAWTHORNE AVE, SUITE A, ATHENS, GA 30606-2194
(706) 548-5227
(706) 353-8134
Mailing address
975 HAWTHORNE AVE, SUITE A, ATHENS, GA 30606-2194
(706) 548-5227
(706) 353-8134
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006424
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031699A
—
GA
01
—
2017475
PK
—
Enumeration date
10/20/2006
Last updated
11/23/2016
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