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General NPI Number Information
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NPI Number | 1225388572
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Entity Type | Organization
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Legal Business Name | CHAMBLEE PHARMACY CORPORATION
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 3652 CHAMBLEE DUNWOODY RD STE 3
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City | ATLANTA
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State | GA
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Zip | 30341-2120
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Country | US
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Telephone | 678-395-7754
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Fax | 678-620-3329
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Provider Business Mailing Address
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Address Line | 3652 CHAMBLEE DUNWOODY RD STE 3
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City | ATLANTA
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State | GA
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Zip | 30341-2120
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Country | US
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Telephone | 678-395-7754
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Fax | 678-620-3329
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Authorized Official
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Title or Position | OWNER
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Name | CECIL JOSEPH
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Credential |
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Telephone | 404-565-6447
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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 | PHRE009842
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License Number State | GA
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