Organization
WEAVERS ROCKY FACE PHARMACY GROUP INC
Active
Other names
WEAVERS ROCKY FACE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL P BRYANT RPH (CFO)
(706) 260-7998
Entity
Organization
Contact information
Practice address
2600 OLD CHATTANOOGA RD, ROCKY FACE, GA 30740-8511
(706) 259-0668
(706) 259-1890
Mailing address
630 TI PI LN, CHATSWORTH, GA 30705-7786
(706) 259-0668
(706) 971-3893
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010622
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411968250A
—
GA
Enumeration date
04/24/2018
Last updated
11/01/2018
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