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Organization
LAWRENCE JOEL ARMY HEALTH CLINIC
Active
Organization
LAWRENCE JOEL ARMY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN RAKESTRAW AGNEW RPH (STAFF PHARMACIST)
(404) 464-0304
Entity
Organization
Contact information
Practice address
1701 HARDEE AVE, FT MCPHERSON, GA 30330
(404) 464-0304
(404) 464-0303
Mailing address
2156 SPINK ST NW, ATLANTA, GA 30318-1154
(404) 792-5919
Taxonomy
Speciality
Code
Description
License number
State
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
Primary
11620
GA
Other
Enumeration date
10/24/2006
Last updated
08/22/2020
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