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General NPI Number Information
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NPI Number | 1134094089
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Entity Type | Organization
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Legal Business Name | RIVERS HEALTH AND WELLNESS PHARMACY
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 170 MARIETTA HWY
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City | CANTON
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State | GA
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Zip | 30114-2303
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Country | US
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Telephone | 770-479-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 607 KNIGHTS BRIDGE DR
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City | CANTON
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State | GA
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Zip | 30115-5215
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Country | US
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Telephone | 770-241-0532
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Fax | 770-241-0532
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN RIVERS
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Credential |
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Telephone | 770-241-0532
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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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