Provider Demographics
NPI:1639690225
Name:MILTON PHARMACY LLC
Entity Type:Organization
Organization Name:MILTON PHARMACY LLC
Other - Org Name:CUMMING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:KATOOT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:404-444-1314
Mailing Address - Street 1:1080 LAURIAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7304
Mailing Address - Country:US
Mailing Address - Phone:404-444-1314
Mailing Address - Fax:
Practice Address - Street 1:907 BUFORD RD STE 600
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-2733
Practice Address - Country:US
Practice Address - Phone:404-444-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty