# LEE GOODRUM PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LEE GOODRUM PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053332015
- **Authorized official:** JOHN GOODRUM BS PHARMACY (CEO)
- **Authorized official phone:** (770) 253-1121

## Contact information

- **Practice address:** 40 HOSPITAL RD, NEWNAN, GA 30263-1201
- **Practice address phone:** (770) 253-1121
- **Practice address fax:** (770) 253-3572
- **Mailing address:** 40 HOSPITAL RD, NEWNAN, GA 30263-1201
- **Mailing address phone:** (770) 253-1121
- **Mailing address fax:** (770) 253-3572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE006304 | GA | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 04/25/2016