Riverside Discount Pharmacy
Pharmacy, Community/Retail Pharmacy in Mableton, GA. Organization (NPI-2).
NPI number1881751154
StatusActive
Last updated in NPPESSep 12, 2007
Details
- NPI
- 1881751154
- Entity type
- Organization (NPI-2)
- Legal business name
- Riverside Discount Pharmacy
- Organization subpart
- No
- Enumeration date
- Jan 3, 2007
- Last updated
- Sep 12, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 007401 | GA | Yes |
| 333600000X | Pharmacy | – | – |
Practice location
705 S Gordon RdSte A
Mableton, GA 30126
Phone 770-732-9342 · Fax 770-732-9347
Mailing address
705 S Gordon RdSte A
Mableton, GA 30126
Authorized official
Christopher Muomah
President
7707329342
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