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General NPI Number Information
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NPI Number | 1871832592
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Entity Type | Organization
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Legal Business Name | NEWNAN PHARMACY INC
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 15 BAKER RD STE 2
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City | NEWNAN
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State | GA
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Zip | 30265-2155
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Country | US
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Telephone | 770-683-6771
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Fax | 770-683-6773
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Provider Business Mailing Address
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Address Line | 15 BAKER RD STE 2
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City | NEWNAN
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State | GA
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Zip | 30265-2155
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Country | US
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Telephone | 770-683-6771
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Fax | 770-683-6773
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Authorized Official
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Title or Position | OWNER
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Name | JOHANNES SMIT
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Credential |
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Telephone | 770-304-1345
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE009898
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License Number State | GA
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