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General NPI Number Information
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NPI Number | 1881288561
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Entity Type | Organization
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Legal Business Name | DAWSON FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 73 PRESTIGE LN STE 104
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City | DAWSONVILLE
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State | GA
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Zip | 30534-6368
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Country | US
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Telephone | 706-203-1400
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Fax | 706-203-1401
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Provider Business Mailing Address
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Address Line | 11067 PEACHCOVE CT
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City | SUWANEE
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State | GA
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Zip | 30024-6103
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Country | US
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Telephone | 678-641-1955
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NARAYANA KANDEPU
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Credential | PH.D
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Telephone | 678-641-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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