Organization
PRUITTHEALTH PHARMACY SERVICES - ATLANTA, INC.
Active
Other names
PruittHealth Pharmacy Services - Atlanta
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL L PRUITT JR. (CHAIRMAN & CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(678) 533-6459
(770) 931-5253
Mailing address
1626 JEURGENS CT, LEGAL DEPT, NORCROSS, GA 30093-2219
(678) 533-6459
(770) 931-5253
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
291U00000X
Clinical Medical Laboratory
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHRE009153
GA
3336H0001X
Home Infusion Therapy Pharmacy
PHRE009153
GA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119656
PK
—
05
—
295907416A
—
GA
Enumeration date
02/20/2007
Last updated
10/07/2021
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