MEDICARE: ATLANTA PHARMACY GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PHRE009749	GA
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2130562	OTHER		PK

General Provider Information

NPI Number	:	1639463847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA PHARMACY GROUP INC

Provider Business Mailing Address
First Line	:	PO BOX 580
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-0580
Country	:	US
Telephone Number	:	770-474-7693
Fax Number	:	770-692-8244

Provider Business Practice Location Address
First Line	:	1262 W PACES FERRY RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-2306
Country	:	US
Telephone Number	:	404-237-7551
Fax Number	:	404-233-1124

Authorized Official
Title or Position	:	OWNER
Name	:	LOREN PIERCE
Credential	:
Telephone Number	:	770-474-7693

Provider Enumeration Date	:	06/06/2011
Last Update Date	:	12/04/2025

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Directions to “ATLANTA PHARMACY GROUP INC ” Practice Location

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