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NPI Code Detail

MEDICARE: EAGLE'S LANDING PHARMACY II

MEDICARE: EAGLE'S LANDING PHARMACY II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPHRE008110GA

General Provider Information

NPI Number : 1366576001
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAGLE'S LANDING PHARMACY II
Provider Business Mailing Address
First Line : 3758 HIGHWAY 42
Second Line : SUITE 201
City : LOCUST GROVE
State : GA
Zip : 30248-3653
Country : US
Telephone Number : 770-957-5556
Fax Number : 770-957-1906
Provider Business Practice Location Address
First Line : 3758 HIGHWAY 42
Second Line : SUITE 201
City : LOCUST GROVE
State : GA
Zip : 30248-3653
Country : US
Telephone Number : 770-957-5556
Fax Number : 770-957-1906
Authorized Official
Title or Position : PRESIDENT
Name : MR. DAVID THOMAS RINK
Credential : RPH
Telephone Number : 770-957-5556
Provider Enumeration Date : 03/15/2007
Last Update Date : 08/22/2020

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Directions to “EAGLE'S LANDING PHARMACY II ” Practice Location

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