<Unavail>

LBN: Due West Pharmacy
<Unavail> is an health care organization with primary practice located at 3880 Due West Rd Nw Ste 118 , Marietta GA 30064-1058. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Due West Pharmacy can be contacted via phone (770) 456-5895, or through Marquess, Jonathan via phone (770) 456-5895.

Contact Information

Primary practice address
3880 Due West Rd Nw Ste 118 Marietta GA 30064-1058
Phone: (770) 456-5895
Fax: (678) 540-6603
Website:
Map and Directions
Authorized official contact:
Name: Marquess, Jonathan
Phone: (770) 456-5895

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X PHRE009933 Georgia

Profile Details

NPI number 1417454455
LBN Legal business name Due West Pharmacy
DBA Doing business as <Unavail>
Authorized official Marquess, Jonathan
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2018
Last updated Apr 6th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417454455 NPPES
Other 2176460 PK
MEDICAID 003139336A PK

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