Organization
RIVERSIDE MOT PHARMACY INC
Active
Other names
RIVERSIDE MOT PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTTIE BARTON (CEO AND PRESIDENT)
(770) 532-6253
Entity
Organization
Contact information
Practice address
935-B GREEN ST, GAINESVILLE, GA 30501
(770) 532-6253
(770) 532-3692
Mailing address
935-B GREEN ST, GAINESVILLE, GA 30501
(770) 532-6253
(770) 532-3692
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
008828
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015567
PK
—
05
—
609612415A
—
GA
Enumeration date
01/02/2007
Last updated
09/24/2015
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