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General NPI Number Information
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NPI Number | 1134564461
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Entity Type | Organization
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Legal Business Name | GAYCO HEALTHCARE NORTH LLC
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 11800 WILLS RD SUITE 150
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City | ALPHARETTA
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State | GA
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Zip | 30009-2079
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Country | US
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Telephone | 770-495-2950
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Fax | 855-568-9477
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Provider Business Mailing Address
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Address Line | 507 INDUSTRIAL BLVD
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City | DUBLIN
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State | GA
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Zip | 31021-1714
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Country | US
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Telephone | 770-495-2950
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Fax | 855-568-9477
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Authorized Official
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Title or Position | CEO
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Name | BENT GAY
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Credential | RPH
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Telephone | 478-353-1579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHRE010193
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License Number State | GA
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