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General NPI Number Information
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NPI Number | 1770041956
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Entity Type | Organization
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Legal Business Name | HOLCOMB BRIDGE WELLNESS PHARMACY INC
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 861 HOLCOMB BRIDGE RD STE 101
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City | ROSWELL
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State | GA
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Zip | 30076-1900
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Country | US
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Telephone | 470-297-5749
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Fax | 470-297-5758
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Provider Business Mailing Address
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Address Line | 861 HOLCOMB BRIDGE RD STE 101
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City | ROSWELL
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State | GA
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Zip | 30076-1900
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Country | US
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Telephone | 678-622-1032
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR ANSELM KWAKU ADDO
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Credential | PHARMAD
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Telephone | 678-622-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic 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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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