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PRESBYTERIAN VILLAGE AUSTELL INC NPI 1396876793


NPI Information

NPI: 1396876793
Provider Name: PRESBYTERIAN VILLAGE AUSTELL INC

Doing Business As: PRESBYTERIAN VILLAGE PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
2000 E WEST CONNECTOR
ATTN: PHARMACY
AUSTELL, GA
ZIP 30106
Phone: (770) 819-7001
Get Directions

PRESBYTERIAN VILLAGE AUSTELL INC is a long term care pharmacy pharmacy in Austell, GA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. PRESBYTERIAN VILLAGE AUSTELL INC NPI is 1396876793. The provider is registered as an organization entity type.
The provider Is Doing Business As Presbyterian Village Pharmacy.

The provider's business location address is:

2000 E WEST CONNECTOR
ATTN: PHARMACY
AUSTELL, GA
ZIP 30106-194
Phone: (770) 819-7001
Fax: (770) 819-7494

The provider's authorized official is Debbie Heritage .
The authorized official title is Dir Of Phcy and has the following contact phone number (770) 819-7001.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 12/8/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
33336L0003XPharmacyLong Term Care PharmacyPHRE009068GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12017513OTHERPK
2666876218AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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