Healthcare Provider Details

I. General information

NPI: 1942124987
Provider Name (Legal Business Name): CAROL EXPRESS ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2462 HEATHERTON CT
DACULA GA
30019-6647
US

IV. Provider business mailing address

2462 HEATHERTON CT
DACULA GA
30019-6647
US

V. Phone/Fax

Practice location:
  • Phone: 385-326-4560
  • Fax:
Mailing address:
  • Phone: 385-326-4560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LOU HODGSON
Title or Position: OWNER
Credential:
Phone: 385-326-4560