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Specialty Pharmacy & Compounding — NPI 1184951337, Cartersville, GA | NPI Central

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NPI 1184951337

OrganizationActive

Specialty Pharmacy & Compounding

NPI 1184951337 · Specialty Pharmacy · Cartersville, GA

Provider details

NPI number: 1184951337
Entity type: Organization
Primary specialty: Specialty PharmacySuppliers
Organization subpart: No
Authorized official: Kevin Callosoe, Secretary(770) 596-6998
License: PHRE009616 (GA)

Specialties & taxonomies

Specialty PharmacyPrimary3336S0011XLicense PHRE009616 (GA)
Suppliers
Pharmacy333600000XLicense PHRE009616 (GA)
Suppliers
Community/Retail Pharmacy3336C0003XLicense PHRE009616 (GA)
Suppliers

Practice location

650 Henderson Dr

Suite 508

Cartersville, GA 30120-3744

Phone: (770) 607-3455

Fax: (770) 607-3457

Approximate (ZIP-level) locationGet directions

More GA providers

Mailing address

650 Henderson Dr

Cartersville, GA 30120-3744

Registry dates

Enumerated: 2009-11-09
Last updated: 2009-11-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.