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NPI Code Detail

MEDICARE: FOOTHILLS PHARMACIES INC

MEDICARE: FOOTHILLS PHARMACIES 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
1333600000XPharmacy8513GA
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31148786OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1912073016
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOOTHILLS PHARMACIES INC
Provider Business Mailing Address
First Line : 100 FRANKLIN SPRINGS ST
Second Line :
City : ROYSTON
State : GA
Zip : 30662-4134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 FRANKLIN SPRINGS ST
Second Line :
City : ROYSTON
State : GA
Zip : 30662-4134
Country : US
Telephone Number : 706-245-9959
Fax Number : 706-245-9555
Authorized Official
Title or Position : OWNER PHARMACIST
Name : R KEITH GOSS
Credential : RPH
Telephone Number : 706-245-9959
Provider Enumeration Date : 11/28/2006
Last Update Date : 03/07/2023

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Directions to “FOOTHILLS PHARMACIES INC ” Practice Location

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