Provider Demographics
NPI:1851572226
Name:SUTTON FAMILY PHARMACY, P.C.
Entity Type:Organization
Organization Name:SUTTON FAMILY PHARMACY, P.C.
Other - Org Name:SUTTON FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-618-1773
Mailing Address - Street 1:761 PRATER MILL RD NE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-7402
Mailing Address - Country:US
Mailing Address - Phone:706-618-1773
Mailing Address - Fax:706-694-3316
Practice Address - Street 1:3957 CLEVELAND HWY
Practice Address - Street 2:UNIT A
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-7402
Practice Address - Country:US
Practice Address - Phone:706-618-1773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0094053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy