Organization
ABUNDANT LIFE PHARMACY & HEALTH FOODS INC
Active
Other names
ABUNDANT LIFE PHARMACY AND HEALTH FOODS INC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HALL PHRMD (OWNER)
(912) 367-8404
Entity
Organization
Contact information
Practice address
117 N MAIN ST, BAXLEY, GA 31513-0070
(912) 367-8404
(912) 367-8405
Mailing address
117 N MAIN ST, BAXLEY, GA 31513-0070
(912) 367-8404
(912) 367-8405
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009480
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017420
PK
—
05
—
359528943A
—
GA
Enumeration date
11/07/2007
Last updated
11/17/2021
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