Provider Demographics
NPI:1255494951
Name:PHARM ASSISTANCE INC
Entity Type:Organization
Organization Name:PHARM ASSISTANCE INC
Other - Org Name:LIVING WELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-422-9355
Mailing Address - Street 1:630 TI PI LN
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-7786
Mailing Address - Country:US
Mailing Address - Phone:706-422-9355
Mailing Address - Fax:
Practice Address - Street 1:79 STATE HWY 286
Practice Address - Street 2:UNIT A
Practice Address - City:ETON
Practice Address - State:GA
Practice Address - Zip Code:30724-0369
Practice Address - Country:US
Practice Address - Phone:706-422-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
GAPHRE0088253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA165398699AMedicaid
GA5225910001Medicare NSC