Provider Demographics
NPI:1639588866
Name:PRECISION PHARMACEUTICALS LLC
Entity Type:Organization
Organization Name:PRECISION PHARMACEUTICALS LLC
Other - Org Name:PRECISION PHARMACEUTICALS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-884-5717
Mailing Address - Street 1:105 SAINT STEPHENS CT STE D
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1716
Mailing Address - Country:US
Mailing Address - Phone:678-884-5717
Mailing Address - Fax:888-491-5616
Practice Address - Street 1:105 SAINT STEPHENS CT STE D
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-1716
Practice Address - Country:US
Practice Address - Phone:678-884-5717
Practice Address - Fax:888-491-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
GA100553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147308OtherPK