Provider Demographics
NPI:1902464571
Name:ATLANTA PHARMACY GROUP, INC.
Entity Type:Organization
Organization Name:ATLANTA PHARMACY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-474-7693
Mailing Address - Street 1:106B ROCK QUARRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3707
Mailing Address - Country:US
Mailing Address - Phone:770-474-7693
Mailing Address - Fax:
Practice Address - Street 1:106B ROCK QUARRY RD STE B
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3707
Practice Address - Country:US
Practice Address - Phone:770-474-7693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTA PHARMACY GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy