# EDISON PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LANE DRUG CO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164570099
- **Authorized official:** EDWARD F REYNOLDS RPH (OWNER MGR)
- **Authorized official phone:** (229) 835-2212

## Contact information

- **Practice address:** 19427 HARTFORD ST, EDISON, GA 39846-5627
- **Practice address phone:** (229) 835-2212
- **Practice address fax:** (229) 835-2572
- **Mailing address:** PO BOX 248, EDISON, GA 39846-0248
- **Mailing address phone:** (229) 835-2211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE000311 | GA | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 10/27/2015