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General NPI Number Information
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NPI Number | 1003238890
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Entity Type | Organization
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Legal Business Name | ROBERTA PHARMACY LLC
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4 WRIGHT AVE
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City | ROBERTA
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State | GA
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Zip | 31078-4932
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Country | US
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Telephone | 478-836-3515
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Fax | 478-836-3319
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Provider Business Mailing Address
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Address Line | PO BOX 418
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City | ROBERTA
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State | GA
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Zip | 31078-0418
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Country | US
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Telephone | 478-836-3515
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Fax | 478-836-3319
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Authorized Official
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Title or Position | OWNER/ PHARMACIST IN CHARGE
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Name | JOSHUA MALCOLM PATTERSON
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Credential |
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Telephone | 478-836-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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