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General NPI Number Information
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NPI Number | 1003500752
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Entity Type | Organization
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Legal Business Name | LENLOCK RX, LLC DBA CLEBURNE PHARMACY
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 21 BILL ROBISON PKWY STE B
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City | ANNISTON
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State | AL
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Zip | 36206-2624
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Country | US
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Telephone | 256-444-6282
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Fax |
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Provider Business Mailing Address
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Address Line | 21 BILL ROBISON PKWY STE B
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City | ANNISTON
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State | AL
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Zip | 36206-2624
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Country | US
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Telephone | 256-444-6282
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANK TANT
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Credential |
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Telephone | 770-680-1997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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