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General NPI Number Information
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NPI Number | 1194216697
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Entity Type | Organization
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Legal Business Name | 874 TOTAL PHARMACY LLC
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 874 RALPH DAVID ABERNATHY BLVD SW
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City | ATLANTA
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State | GA
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Zip | 30310-1829
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Country | US
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Telephone | 470-355-8584
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Fax | 470-355-8593
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Provider Business Mailing Address
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Address Line | PO BOX 3028
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City | DULUTH
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State | GA
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Zip | 30096-0052
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Country | US
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Telephone | 470-355-8584
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. APRIL HANG
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Credential | PHARM.D
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Telephone | 678-337-8814
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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 | PHRE010627
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License Number State | GA
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