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General NPI Number Information
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NPI Number | 1558557421
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Entity Type | Organization
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Legal Business Name | ASSISTED LIVING PHARMACY INC
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 35 W MIDLAND AVE SUITE B
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City | WINDER
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State | GA
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Zip | 30680-2564
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Country | US
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Telephone | 770-867-3550
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Fax | 770-867-3566
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Provider Business Mailing Address
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Address Line | 35 W MIDLAND AVE SUITE B
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City | WINDER
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State | GA
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Zip | 30680-2564
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Country | US
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Telephone | 770-867-3550
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Fax | 770-867-3566
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Authorized Official
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Title or Position | PHARM D / OWNER
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Name | AMY KATHRYN DUNAHOO
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Credential |
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Telephone | 770-867-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RPH016800
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License Number State | GA
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