WESTSIDE PHARMACY, INC.
Ambulatory Health at West Ave, Euharlee, GA

License number
Georgia PHRE008729
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DAVID W DEXTER R.PH.
Title: PRESIDENT
Phone: (770) 387-3455
Address
Address
775 West Ave WEST SUITE C, Euharlee, GA 30120
National Provider ID: 1083711022
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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WESTSIDE PHARMACY, INC

Euharlee, GA

Status:
Inactive
Industry:
Pharmacy
Registration:
Mar 19, 2003
Inactive since:
Sep 5, 2010
Phone:
(770) 387-3455 (Phone)
Addresses:
775 W Ave SUITE C, Cartersville, GA 30120 (Physical)
75 Douthit Fry Rd, Euharlee, GA 30120
State ID:
0317242
Business type:
Domestic Profit Corporation
Owners:
W. David Dexter (CFO), 775 W Ave SUITE C, Cartersville, GA 30120 (Physical),David W. Dexter President, Chief Executive Officer, Chief Financial Officer, Secretary, inactive,Mahendra Patel Owner, inactive

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