Provider Demographics
NPI:1992866321
Name:WENDER & ROBERTS, INC
Entity Type:Organization
Organization Name:WENDER & ROBERTS, INC
Other - Org Name:WENDER & ROBERTS #2
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-442-3504
Mailing Address - Street 1:11285 ELKINS RD
Mailing Address - Street 2:SUITE K-4
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1259
Mailing Address - Country:US
Mailing Address - Phone:770-442-3504
Mailing Address - Fax:770-442-3506
Practice Address - Street 1:1262 W PACES FERRY RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2306
Practice Address - Country:US
Practice Address - Phone:404-237-7551
Practice Address - Fax:404-233-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00565397BMedicaid