| Organization Name: | EXPRESS FOOD AND PHARMACY INC |
| NPI Number: | 1295138204 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KETAN TRIVEDI (PHARMACIST) |
| Mailing Address: | 3685 Braselton Hwy Ste 101102 Dacula |
| State: | GA US |
| Postal Code: | 300195920 |
| Phone Number: | 6788892131 |
| Fax Number: | 6788892135 |
| NPI Enumeration Date: | 10/03/2014 |
| NPI Last Update Date: | 02/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |