Provider Demographics
NPI:1881992873
Name:PIEDMONT PHARMACY INC
Entity type:Organization
Organization Name:PIEDMONT PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUCHARIA
Authorized Official - Middle Name:U
Authorized Official - Last Name:ANUNOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-788-9191
Mailing Address - Street 1:4104 TATE ST NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2551
Mailing Address - Country:US
Mailing Address - Phone:770-788-9191
Mailing Address - Fax:770-788-6292
Practice Address - Street 1:4104 TATE ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2551
Practice Address - Country:US
Practice Address - Phone:770-788-9191
Practice Address - Fax:770-788-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0097333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy