MEDICARE: MRS. LORI SMITH GARNER R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH015414	GA
2	183500000X	Pharmacist	PS23800	FL

General Provider Information

NPI Number	:	1598935579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI SMITH GARNER R.PH.

Provider Business Mailing Address
First Line	:	5249 SANDLEWOOD CT
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-2887
Country	:	US
Telephone Number	:	404-657-7241
Fax Number	:	404-657-5461

Provider Business Practice Location Address
First Line	:	2 PEACHTREE ST NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3141
Country	:	US
Telephone Number	:	404-657-7241
Fax Number	:	404-657-5461

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

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