Organization
VINA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAN VO (PARTNER)
(404) 664-8659
Entity
Organization
Contact information
Practice address
969 WINDY HILL RD SE, STE N, SMYRNA, GA 30080-2003
(770) 805-0207
(770) 805-0209
Mailing address
969 WINDY HILL RD SE, STE N, SMYRNA, GA 30080-2003
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009039
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154563
OTHER ID NUMBER
—
Enumeration date
08/10/2006
Last updated
03/12/2008
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