Provider Demographics
NPI:1063154961
Name:JM CARDINAL INVESTMENTS LLC MEDICAL QUARTERS
Entity type:Organization
Organization Name:JM CARDINAL INVESTMENTS LLC MEDICAL QUARTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PAMALA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:MARQUESS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:678-463-9598
Mailing Address - Street 1:15 ALLATOONA TRACE DR SE
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-3805
Mailing Address - Country:US
Mailing Address - Phone:678-463-9598
Mailing Address - Fax:770-971-0315
Practice Address - Street 1:5555 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1703
Practice Address - Country:US
Practice Address - Phone:404-252-3607
Practice Address - Fax:404-252-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy