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General NPI Number Information
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NPI Number | 1144244740
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Entity Type | Organization
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Legal Business Name | JM CARDINAL INVESTMENTS LLC EMORY CRAWFORD LONG
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE STE 1450
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-523-4908
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Fax | 404-523-9049
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Provider Business Mailing Address
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Address Line | 8612 MAIN ST
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City | WOODSTOCK
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State | GA
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Zip | 30188-4829
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Country | US
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Telephone | 678-285-0760
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Fax | 770-971-0315
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Authorized Official
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Title or Position | OWNER
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Name | WILLIE D SMITH
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Credential |
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Telephone | 678-463-9598
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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 | PHRE008632
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License Number State | GA
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