Provider Demographics
NPI:1033084983
Name:RIVERS HEALTH AND WELLNESS PHARMACY
Entity type:Organization
Organization Name:RIVERS HEALTH AND WELLNESS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-241-0532
Mailing Address - Street 1:607 KNIGHTS BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-5215
Mailing Address - Country:US
Mailing Address - Phone:770-241-0532
Mailing Address - Fax:
Practice Address - Street 1:6824 REINHARDT COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:WALESKA
Practice Address - State:GA
Practice Address - Zip Code:30183-3266
Practice Address - Country:US
Practice Address - Phone:770-479-2172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERS HEALTH AND WELLNESS PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy