Healthcare Provider Details

I. General information

NPI: 1700725413
Provider Name (Legal Business Name): LEGBEX PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 ATHENS HWY STE 105
GRAYSON GA
30017-1762
US

IV. Provider business mailing address

1142 ATHENS HWY STE 105
GRAYSON GA
30017-1762
US

V. Phone/Fax

Practice location:
  • Phone: 470-782-9355
  • Fax: 470-208-2613
Mailing address:
  • Phone: 470-782-9355
  • Fax: 470-208-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHIGBO ANTHONY AGBASIONWE
Title or Position: OWNER / MANAGING MEMBER
Credential: PHARMD, MBA
Phone: 917-500-0565