# OLD NORCROSS ROAD PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Old Norcross Road Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174852966
- **Authorized official:** LINUS IGBOKWE (DIRECTOR/ OWNER)
- **Authorized official phone:** (770) 682-8622

## Contact information

- **Practice address:** 558 OLD NORCROSS RD, SUITE 201, LAWRENCEVILLE, GA 30046-4385
- **Practice address phone:** (770) 682-8622
- **Practice address fax:** (770) 682-8623
- **Mailing address:** 558 OLD NORCROSS RD, SUITE 201, LAWRENCEVILLE, GA 30046-4385
- **Mailing address phone:** (770) 682-8622
- **Mailing address fax:** (770) 682-8623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009621 | GA | Yes |

## Other

- **Enumeration date:** 12/08/2009
- **Last updated:** 08/10/2010