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General NPI Number Information
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NPI Number | 1417357385
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Entity Type | Organization
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Legal Business Name | ADDISON HEALTHCARE INC
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 11205 ALPHARETTA HWY F-1
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City | ROSWELL
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State | GA
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Zip | 30076-5610
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Country | US
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Telephone | 678-395-3213
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Fax |
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Provider Business Mailing Address
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Address Line | 11205 ALPHARETTA HWY F-1
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City | ROSWELL
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State | GA
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Zip | 30076-5610
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Country | US
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Telephone | 678-395-3213
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ADRRYL S ADDISON
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Credential | PHARMD
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Telephone | 678-395-3213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHRE010066
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License Number State | GA
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