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General NPI Number Information
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NPI Number | 1487914065
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Entity Type | Organization
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Legal Business Name | PHYSICIANS PHARMACY ALLIANCE , INC
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 4345 INTERNATIONAL PKWY SUITE 100
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City | ATLANTA
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State | GA
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Zip | 30354-3911
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Country | US
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Telephone | 404-633-6656
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Fax | 404-634-6657
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Provider Business Mailing Address
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Address Line | 4345 INTERNATIONAL PKWY SUITE 100
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City | ATLANTA
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State | GA
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Zip | 30354-3911
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Country | US
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Telephone | 404-633-6656
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Fax | 404-634-6657
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | DEANNA MCFADDEN
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Credential |
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Telephone | 866-463-5550
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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 | PHRE009833
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License Number State | GA
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