Avita Pharmacy 1046

LBN: Longs Drugs Of Sandersville Georgia Inc
Avita Pharmacy 1046 is an health care organization with primary practice located at 2140 Peachtree Rd Nw Suite 232, Atlanta GA 30309-1316. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Longs Drugs Of Sandersville Georgia Inc can be contacted via phone (404) 231-4431, or through Colquitt, Carl Cody via phone (469) 592-2011.

Contact Information

Primary practice address
2140 Peachtree Rd Nw Suite 232 Atlanta GA 30309-1316
Phone: (404) 231-4431
Fax: (404) 231-5677
Website:
Map and Directions
Authorized official contact:
Name: Colquitt, Carl Cody
Phone: (469) 592-2011

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009702 Georgia

Profile Details

NPI number 1053357509
LBN Legal business name Longs Drugs Of Sandersville Georgia Inc
DBA Doing business as Avita Pharmacy 1046
Authorized official Colquitt, Carl Cody
Entity Organization
Organization subpart 1 No
Enumeration date Jun 22nd, 2006
Last updated Dec 11th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053357509 NPPES
Other 1148279 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 003291812A NCPDP PROVIDER IDENTIFICATION NUMBER

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