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General NPI Number Information
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NPI Number | 1932477817
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Entity Type | Organization
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Legal Business Name | ARTEM PHARMACEUTICA LLC
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 595 ROSWELL ST NE STE D
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City | MARIETTA
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State | GA
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Zip | 30060-2163
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Country | US
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Telephone | 770-944-3626
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Fax | 770-944-3627
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Provider Business Mailing Address
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Address Line | 595 ROSWELL ST NE SUITE D
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City | MARIETTA
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State | GA
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Zip | 30060-8218
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Country | US
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Telephone | 770-944-3626
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Fax | 770-944-3627
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Authorized Official
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Title or Position | PHARMACIST
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Name | MARTIN WODI
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Credential |
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Telephone | 770-944-3626
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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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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHRE009815
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License Number State | GA
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