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Organization
LACEY DRUG COMPANY INC
Active
Organization
LACEY DRUG COMPANY INC
Active
Other names
LACEYS LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BENNIE FLANAGAN (V-P)
(678) 236-0400
Entity
Organization
Contact information
Practice address
4469 LEMON ST, ACWORTH, GA 30101-5418
(678) 236-0400
(678) 236-0404
Mailing address
4469 LEMON ST, ACWORTH, GA 30101-5418
(678) 236-0400
(678) 236-0404
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
PHRE008914
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015785
PK
—
05
—
30357C
—
GA
Enumeration date
08/20/2006
Last updated
09/14/2016
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