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General NPI Number Information
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NPI Number | 1699847475
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Entity Type | Organization
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Legal Business Name | LANIER PHARMACY ACQUISITION CORP.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 3560 THOMPSON BRIDGE RD
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City | GAINESVILLE
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State | GA
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Zip | 30506-1518
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Country | US
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Telephone | 770-536-8861
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Fax | 770-503-1201
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Provider Business Mailing Address
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Address Line | 3560 THOMPSON BRIDGE RD
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City | GAINESVILLE
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State | GA
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Zip | 30506-1518
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Country | US
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Telephone | 770-536-8861
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Fax | 770-503-1201
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Authorized Official
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Title or Position | PRES/OWNER/RPH/AO
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Name | STEPHEN ADAMS
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Credential | RPH
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Telephone | 770-536-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | PHRE007887
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License Number State | GA
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