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General NPI Number Information
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NPI Number | 1760399950
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE PHARMACY & HEALTH FOODS INC
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 117 N MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0070
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Country | US
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Telephone | 912-367-8404
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Fax | 912-367-8405
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Provider Business Mailing Address
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Address Line | 117 N MAIN ST
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City | BAXLEY
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State | GA
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Zip | 31513-0070
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Country | US
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Telephone | 912-367-8404
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Fax | 912-367-8405
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Authorized Official
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Title or Position | OWNER
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Name | LISA LYNN HALL
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Credential | PHARMACIST
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Telephone | 912-367-8404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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