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General NPI Number Information
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NPI Number | 1467506212
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Entity Type | Organization
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Legal Business Name | UNION PHARMACY
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 624 SIBLEY AVE
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City | UNION POINT
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State | GA
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Zip | 30669-1140
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Country | US
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Telephone | 706-486-2131
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Fax | 706-486-2132
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Provider Business Mailing Address
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Address Line | 624 SIBLEY AVE P. O. BOX 303
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City | UNION POINT
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State | GA
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Zip | 30669-1140
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Country | US
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Telephone | 706-486-2131
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Fax | 706-486-2132
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Authorized Official
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Title or Position | CEO
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Name | JAMES CARPENTER
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Credential | RPH
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Telephone | 706-486-2131
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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 | PHRE002986
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License Number State | GA
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