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NPI Code Detail

MEDICARE: DREAM PHARMACY

MEDICARE: DREAM PHARMACY
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail PharmacyPHRE009122GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22016475OTHERPK

General Provider Information

NPI Number : 1740321603
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREAM PHARMACY
Provider Business Mailing Address
First Line : 1299 OLD PEACHTREE RD NW
Second Line :
City : SUWANEE
State : GA
Zip : 30024-2028
Country : US
Telephone Number : 770-814-4515
Fax Number : 770-814-4516
Provider Business Practice Location Address
First Line : 1299 OLD PEACHTREE RD NW
Second Line :
City : SUWANEE
State : GA
Zip : 30024-2028
Country : US
Telephone Number : 770-814-4515
Fax Number : 770-814-4516
Authorized Official
Title or Position : OWNER
Name : YOO BYUNG DOO
Credential :
Telephone Number : 770-814-4515
Provider Enumeration Date : 02/12/2007
Last Update Date : 06/06/2024

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Directions to “DREAM PHARMACY ” Practice Location

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