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DUE WEST PHARMACY NPI 1417454455


NPI Information

NPI: 1417454455
Provider Name: DUE WEST PHARMACY

Doing Business As: DUE WEST PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
3880 DUE WEST RD NW STE 118
MARIETTA, GA
ZIP 30064
Phone: (770) 456-5895
Get Directions

DUE WEST PHARMACY is a long term care pharmacy pharmacy in Marietta, GA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. DUE WEST PHARMACY NPI is 1417454455. The provider is registered as an organization entity type.
The provider Is Doing Business As Due West Pharmacy.

The provider's business location address is:

3880 DUE WEST RD NW STE 118
MARIETTA, GA
ZIP 30064-058
Phone: (770) 456-5895
Fax: (678) 540-6603

The provider's authorized official is Jonathan Marquess .
The authorized official title is Pharm D and has the following contact phone number (770) 456-5895.

The enumeration date for this NPI number is 4/6/2018 and was last updated on 4/6/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336L0003XPharmacyLong Term Care PharmacyPHRE009933GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003139336AMEDICAIDGEORGIA
22176460OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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