Provider Demographics
NPI:1548465263
Name:ABCAE, P. C.
Entity type:Organization
Organization Name:ABCAE, P. C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-436-0811
Mailing Address - Street 1:3903 S COBB DR SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6342
Mailing Address - Country:US
Mailing Address - Phone:770-436-0811
Mailing Address - Fax:770-436-1810
Practice Address - Street 1:3903 S COBB DR SE
Practice Address - Street 2:SUITE 103
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6342
Practice Address - Country:US
Practice Address - Phone:770-436-0811
Practice Address - Fax:770-436-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1155793OtherNCPDP #
GA1155793OtherNCPDP #
GA5966470001Medicare NSC