Provider Demographics
NPI:1275247918
Name:MEDICINE POINTE PHARMACY LLC
Entity Type:Organization
Organization Name:MEDICINE POINTE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:KINJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-580-5354
Mailing Address - Street 1:254 LAKESTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5456
Mailing Address - Country:US
Mailing Address - Phone:404-205-5033
Mailing Address - Fax:404-506-9062
Practice Address - Street 1:2881 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3371
Practice Address - Country:US
Practice Address - Phone:404-205-5033
Practice Address - Fax:404-506-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy