# LILBURN COMMUNITY PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lilburn Community Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134563406
- **Authorized official:** SAMINA C KHATRI PHARMACY (OWNER/ORGANIZER)
- **Authorized official phone:** (770) 710-0478

## Contact information

- **Practice address:** 4025 LAWRENCEVILLE HWY NW STE D, LILBURN, GA 30047-2876
- **Practice address phone:** (770) 710-0478
- **Practice address fax:** (770) 710-0861
- **Mailing address:** 2147 WHITESTONE CT SE, SMYRNA, GA 30080-3116
- **Mailing address phone:** (404) 909-8052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE009917 | GA | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/17/2013
- **Last updated:** 05/04/2024