Healthcare Provider Details

I. General information

NPI: 1942756176
Provider Name (Legal Business Name): MED-4-YOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 PEACHTREE INDUSTRIAL BLVD
BERKELEY LAKE GA
30096-4809
US

IV. Provider business mailing address

3970 PEACHTREE INDUSTRIAL BLVD SUITE#200
BERKELEY LAKE GA
30096-4809
US

V. Phone/Fax

Practice location:
  • Phone: 470-299-5292
  • Fax: 470-395-9140
Mailing address:
  • Phone: 470-299-5292
  • Fax: 470-395-9140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE010306
License Number StateGA

VIII. Authorized Official

Name: ALI LAVASSANI
Title or Position: PHARMACIST
Credential:
Phone: 404-587-8099