Healthcare Provider Details

I. General information

NPI: 1811212012
Provider Name (Legal Business Name): JOHNSON'S HOMETOWN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 THOMPSON MILL RD
HOSCHTON GA
30548-4133
US

IV. Provider business mailing address

PO BOX 629
BUFORD GA
30515-0629
US

V. Phone/Fax

Practice location:
  • Phone: 770-315-4103
  • Fax: 770-932-6169
Mailing address:
  • Phone: 770-945-9501
  • Fax: 770-932-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ANTHONY JOHNSON
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 770-315-4103