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General NPI Number Information
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NPI Number | 1063762425
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Entity Type | Individual
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Provider Name | NANCY N LAFAVOR RPH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 150 JOHNNY MERCER BLVD
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City | SAVANNAH
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State | GA
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Zip | 31410
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Country | US
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Telephone | 912-897-3220
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Fax | 912-898-5383
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Provider Business Mailing Address
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Address Line | PO BOX 1745 62 VAN HORN
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City | TYBEE ISLAND
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State | GA
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Zip | 31328-1745
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Country | US
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Telephone | 912-786-5642
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Fax | 912-898-5383
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4756
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License Number State | SC
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