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General NPI Number Information
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NPI Number | 1093211005
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Entity Type | Organization
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Legal Business Name | CTCA RX, LLC
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 610 CELEBRATE LIFE PKWY
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City | NEWNAN
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State | GA
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Zip | 30265-8001
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Country | US
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Telephone | 678-552-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 610 CELEBRATE LIFE PKWY
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City | NEWNAN
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State | GA
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Zip | 30265-8001
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Country | US
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Telephone | 678-552-2013
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHRIS LEHMER
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Credential |
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Telephone | 678-552-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE010615
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License Number State | GA
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