Organization
KAT INTERNATIONAL GROUP INC
Active
Other names
FAIRWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMPSON AGYEMANG (RPH/OWNER)
(678) 493-5959
Entity
Organization
Contact information
Practice address
1750 MARIETTA HWY STE 260, CANTON, GA 30114-8388
(678) 493-5959
(678) 493-3546
Mailing address
1750 MARIETTA HWY, SUITE 260, CANTON, GA 30114-8387
(678) 493-5959
(678) 493-3546
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009761
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110325
—
GA
01
—
1161570
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2011
Last updated
08/29/2011
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