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General NPI Number Information
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NPI Number | 1376702498
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Entity Type | Organization
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Legal Business Name | WENDER & ROBERTS ASSISTED LIVING
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 10930 CRABAPPLE RD SUITE 7 B
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City | ROSWELL
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State | GA
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Zip | 30075-5813
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Country | US
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Telephone | 770-992-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 10930 CRABAPPLE RD SUITE 7 B
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City | ROSWELL
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State | GA
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Zip | 30075-5813
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Country | US
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Telephone | 770-992-7300
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CAREY C. COGGINS
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Credential | RPH
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Telephone | 770-992-7300
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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 | PHRE009446
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License Number State | GA
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