Organization Name: | CANTON NORTHSIDE PHARMACY INC |
NPI Number: | 1861492761 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARRELL CHESTER (PRES) |
Mailing Address: | 170 Marietta Hwy Canton |
State: | GA US |
Postal Code: | 301142303 |
Phone Number: | 7704792171 |
Fax Number: | 7707206006 |
NPI Enumeration Date: | 07/21/2005 |
NPI Last Update Date: | 12/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |