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General NPI Number Information
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NPI Number | 1174830475
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Entity Type | Organization
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Legal Business Name | ADVANCED PHARMACY LLC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 350 FEASTER RD STE D
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City | GREENVILLE
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State | SC
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Zip | 29615-6176
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Country | US
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Telephone | 770-339-1190
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Fax | 888-610-3138
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Provider Business Mailing Address
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Address Line | 1576 ATKINSON RD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5701
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Country | US
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Telephone | 770-339-1190
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Fax | 888-901-2030
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY SANTULLI
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Credential |
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Telephone | 770-339-1190
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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 | 14847
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License Number State | SC
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