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General NPI Number Information
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NPI Number | 1013447044
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Entity Type | Organization
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Legal Business Name | PHARMACY INVESTMENTS OF LAWRENCEVILLE, LLC
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 738 OLD NORCROSS ROAD STE A (#120)
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 678-878-2087
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Fax | 678-878-2088
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Provider Business Mailing Address
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Address Line | 738 OLD NORCROSS ROAD STE A (# 120)
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-1234
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Country | US
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Telephone | 678-878-2087
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Fax | 678-878-2088
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | MR. MANISH PATEL X
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Credential |
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Telephone | 789-338-9656
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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 | PHRE010354
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License Number State | GA
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