Provider Demographics
NPI:1568935757
Name:NEIGHBORCARE PHARMACY
Entity Type:Organization
Organization Name:NEIGHBORCARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-570-9362
Mailing Address - Street 1:3 SHORT ST.
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064
Mailing Address - Country:US
Mailing Address - Phone:762-435-7019
Mailing Address - Fax:762-435-7020
Practice Address - Street 1:3 SHORT ST.
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064
Practice Address - Country:US
Practice Address - Phone:762-435-7019
Practice Address - Fax:762-435-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy