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General NPI Number Information
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NPI Number | 1710311766
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Entity Type | Individual
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Provider Name | LAURIE COOK WINDHAM PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 1850 JONESBORO RD
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City | MCDONOUGH
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State | GA
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Zip | 30253-5960
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Country | US
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Telephone | 678-583-2184
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 JACKSON SPRINGS RD
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City | MACON
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State | GA
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Zip | 31211-1732
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Country | US
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Telephone | 334-389-0016
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Fax |
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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 | RPH027335
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License Number State | GA
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