Healthcare Provider Details

I. General information

NPI: 1427460757
Provider Name (Legal Business Name): MCARTHURS APOTHECARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDGEWOOD AVE SE STE 200B
ATLANTA GA
30312-1935
US

IV. Provider business mailing address

593 EDGEWOOD AVE SE STE 200B
ATLANTA GA
30312-1935
US

V. Phone/Fax

Practice location:
  • Phone: 404-523-6337
  • Fax: 678-705-3924
Mailing address:
  • Phone: 404-523-6337
  • Fax: 678-705-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE010172
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAKIA SHAW
Title or Position: CEO
Credential:
Phone: 404-735-9200