Provider Demographics
NPI:1245692862
Name:NEIGHBORHOOD IMPROVEMENT PROJECT INC
Entity type:Organization
Organization Name:NEIGHBORHOOD IMPROVEMENT PROJECT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:PURNANK
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-922-0682
Mailing Address - Street 1:2467 GOLDEN CAMP RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-5515
Mailing Address - Country:US
Mailing Address - Phone:706-922-0682
Mailing Address - Fax:706-922-0683
Practice Address - Street 1:501 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WRENS
Practice Address - State:GA
Practice Address - Zip Code:30833-1185
Practice Address - Country:US
Practice Address - Phone:706-547-2550
Practice Address - Fax:706-547-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 333600000X
GAPHRE0102713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158603OtherPK