| Westside Pharmacy, Inc. | |
|
775 West Ave Suite C Cartersville GA 30120-3481 | |
| (770) 387-3455 | |
| (770) 387-3465 |
| Full Name | Westside Pharmacy, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 775 West Ave, Cartersville, Georgia |
| Authorized Official Name and Position | David W Dexter (PRESIDENT) |
| Authorized Official Contact | 7703873455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Westside Pharmacy, Inc. 775 West Ave Suite C Cartersville GA 30120-3481 Ph: (770) 387-3455 | Westside Pharmacy, Inc. 775 West Ave Suite C Cartersville GA 30120-3481 Ph: (770) 387-3455 |
| NPI Number | 1083711022 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083711022 | NPI | - | NPPES |
| 0008141736C | Medicaid | GA | |
| 1151048 | Other | NCPDP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | PHRE008729 (Georgia) | Primary |
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