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General NPI Number Information
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NPI Number | 1922309103
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Entity Type | Organization
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Legal Business Name | SENOIA DRUG CO INC.
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 7285 HIGHWAY 16 SUITE A
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City | SENOIA
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State | GA
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Zip | 30276-3357
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Country | US
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Telephone | 770-727-3060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | SENOIA
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State | GA
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Zip | 30276-0280
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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 | PRESIDENT
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Name | DR. JAMES B HAZELTON
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Credential |
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Telephone | 770-313-5072
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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 | PHRE009706
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License Number State | GA
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