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General NPI Number Information
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NPI Number | 1710481825
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Entity Type | Organization
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Legal Business Name | BRIARCLIFF PHARMACY, INC
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 2724 CLAIRMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-2760
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Country | US
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Telephone | 404-728-0092
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Fax | 404-633-8905
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Provider Business Mailing Address
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Address Line | 8612 MAIN ST
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City | WOODSTOCK
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State | GA
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Zip | 30188-4829
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Country | US
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Telephone | 678-285-0760
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Fax | 770-971-0315
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN MARQUESS
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Credential |
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Telephone | 678-285-0760
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHRE008616
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License Number State | GA
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