Express Pharmacy

LBN: Express At Northside Llc
Express Pharmacy is an health care organization with primary practice located at 296 Northside Dr Sw , Atlanta GA 30313-1228. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Express At Northside Llc can be contacted via phone (404) 549-7762, or through Trivedi, Ketan via phone (678) 205-7038.

Contact Information

Primary practice address
296 Northside Dr Sw Atlanta GA 30313-1228
Phone: (404) 549-7762
Fax: (404) 549-7625
Website:
Map and Directions
Authorized official contact:
Name: Trivedi, Ketan
Phone: (678) 205-7038

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE010415 Georgia
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1285145789
LBN Legal business name Express At Northside Llc
DBA Doing business as Express Pharmacy
Authorized official Trivedi, Ketan
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2017
Last updated Jul 19th, 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 1285145789 NPPES
Georgia MEDICAID 003199602A
Georgia Other 2172400

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