Organization
GEORGIA REGIONAL HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONNY SLATE COO (CHIEF OPERATIONS OFFICER)
(404) 243-2121
Entity
Organization
Contact information
Practice address
3073 PANTHERSVILLE ROAD, PATIENT ACCOUNTS OFFICE, DECATUR, GA 30034-3828
(404) 243-2158
(404) 243-2159
Mailing address
P.O. BOX 370407, PATIENT ACCOUNTS OFFICE, DECATUR, GA 30034-3828
(404) 243-2158
(404) 243-2159
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
044-232
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000355715A
PHARMACY PROVIDER NUMBER
GA
01
—
1119723
PHARMACY
—
Enumeration date
03/15/2007
Last updated
08/14/2009
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