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Organization
FOX PHARMACY LLC
Active
Organization
FOX PHARMACY LLC
Active
Other names
FOX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS TRACEY (MANG MEMBER)
(678) 373-3918
Entity
Organization
Contact information
Practice address
905 PARKSIDE WALK LN, STE 108, LAWRENCEVILLE, GA 30043-7314
(678) 373-3918
(678) 373-3921
Mailing address
905 PARKSIDE WALK LN, STE 108, LAWRENCEVILLE, GA 30043-7314
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009370
GA
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
10/04/2007
Last updated
03/12/2008
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