# ABUNDANT LIFE PHARMACY & HEALTH FOODS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ABUNDANT LIFE PHARMACY AND HEALTH FOODS INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003096025
- **Authorized official:** LISA HALL PHRMD (OWNER)
- **Authorized official phone:** (912) 367-8404

## Contact information

- **Practice address:** 117 N MAIN ST, BAXLEY, GA 31513-0070
- **Practice address phone:** (912) 367-8404
- **Practice address fax:** (912) 367-8405
- **Mailing address:** 117 N MAIN ST, BAXLEY, GA 31513-0070
- **Mailing address phone:** (912) 367-8404
- **Mailing address fax:** (912) 367-8405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE009480 | GA | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 11/17/2021