Organization
PRUITTHEALTH PHARMACY SERVICES - NORCROSS, INC.
Active
Other names
PruittHealth Pharmacy Services - Christian City
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL L. PRUITT JR. (CHAIRMAN & CEO OF MGR)
(770) 279-6200
Entity
Organization
Contact information
Practice address
1626 JEURGENS CT, BLDG 100 STE B, NORCROSS, GA 30093
(770) 279-6200
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
3336C0003X
Community/Retail Pharmacy
PHRE009656
GA
3336I0012X
Institutional Pharmacy
PHRE009656
GA
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009656
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1160023
NCPDP
GA
05
—
474085527A
—
GA
Enumeration date
11/04/2009
Last updated
09/02/2025
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