Organization
JM CARDINAL INVESTMENTS LLC LAWRENCEVILLE
Active
Other names
Concord Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE D SMITH (OWNER)
(678) 463-9598
Entity
Organization
Contact information
Practice address
575 PROFESSIONAL DR STE 170, LAWRENCEVILLE, GA 30046-3335
(770) 338-0971
(770) 338-5275
Mailing address
8612 MAIN ST, WOODSTOCK, GA 30188-4829
(678) 285-0760
(770) 971-0315
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008760
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00322858J
—
GA
Enumeration date
07/27/2006
Last updated
04/11/2023
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