MEDICARE: HEADLAND PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH022959	GA

General Provider Information

NPI Number	:	1003227711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEADLAND PHARMACY

Provider Business Mailing Address
First Line	:	2925 HEADLAND DR
Second Line	:	SUITE 2000
City	:	EAST POINT
State	:	GA
Zip	:	30344-1906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2925 HEADLAND DR
Second Line	:	SUITE 2000
City	:	EAST POINT
State	:	GA
Zip	:	30344-1906
Country	:	US
Telephone Number	:	404-226-6300
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MARGOT Y GARRICK
Credential	:	PHARMD
Telephone Number	:	404-226-6300

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	05/15/2014

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