Provider Demographics
NPI:1417558339
Name:MY PHARMACIST FRIEND, LLC
Entity type:Organization
Organization Name:MY PHARMACIST FRIEND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-941-6269
Mailing Address - Street 1:PO BOX 733
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-0013
Mailing Address - Country:US
Mailing Address - Phone:678-725-3430
Mailing Address - Fax:
Practice Address - Street 1:1584 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-4323
Practice Address - Country:US
Practice Address - Phone:860-882-4035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center