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General NPI Number Information
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NPI Number | 1003109422
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Entity Type | Organization
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Legal Business Name | ASHLYN DRUGS
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 1160 OLD HARRIS RD
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City | DALLAS
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State | GA
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Zip | 30132
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Country | US
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Telephone | 770-443-0205
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Fax | 770-443-0205
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Provider Business Mailing Address
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Address Line | 202 BEACON CV
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City | CANTON
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State | GA
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Zip | 30114-5892
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Country | US
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Telephone | 770-712-8560
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Fax | 770-479-0708
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DAVID GRIFFIN
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Credential |
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Telephone | 770-712-8560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE009771
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License Number State | GA
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