Healthcare Provider Details

I. General information

NPI: 1043103559
Provider Name (Legal Business Name): ALLCARE PHARMACY AND COMPOUNDING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S OXLEY DR
LYONS GA
30436-5645
US

IV. Provider business mailing address

PO BOX 1336
LYONS GA
30436-6336
US

V. Phone/Fax

Practice location:
  • Phone: 912-526-3200
  • Fax:
Mailing address:
  • Phone: 912-687-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY NAGEL
Title or Position: OWNER
Credential: PHARMD
Phone: 912-687-5512