Organization
FOOTHILLS PHARMACIES INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
R KEITH GOSS RPH (OWNER PHARMACIST)
(706) 245-9959
Entity
Organization
Contact information
Practice address
100 FRANKLIN SPRINGS ST, ROYSTON, GA 30662-4134
(706) 245-9959
(706) 245-9555
Mailing address
100 FRANKLIN SPRINGS ST, ROYSTON, GA 30662-4134
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
8513
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000914713B
—
GA
05
—
00914713A
—
GA
01
—
1148786
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/28/2006
Last updated
03/07/2023
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