Healthcare Provider Details

I. General information

NPI: 1659756419
Provider Name (Legal Business Name): LAUREN GRAHAM COWANS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 01/04/2023
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 W PEACHTREE ST NW
ATLANTA GA
30308-1199
US

IV. Provider business mailing address

740 W PEACHTREE ST NW
ATLANTA GA
30308-1199
US

V. Phone/Fax

Practice location:
  • Phone: 866-787-6341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18869
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH029633
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: