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General NPI Number Information
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NPI Number | 1730637562
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Entity Type | Organization
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Legal Business Name | HEADLAND PHARMACY LLC
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 2973 HEADLAND DR SW SUITE B
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City | ATLANTA
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State | GA
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Zip | 30311-5434
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Country | US
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Telephone | 404-344-0209
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Fax |
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Provider Business Mailing Address
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Address Line | 2973 HEADLAND DR SW SUITE B
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City | ATLANTA
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State | GA
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Zip | 30311-5434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/ OWNER
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Name | MARGOT GARRICK
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Credential |
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Telephone | 404-226-6300
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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 | PHRE010293
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License Number State | GA
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