Organization
LINDALE HOMETOWN PHARMACY LLC
Active
Other names
Lindale Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY PATTERSON (OWNER/PHARMACIST)
(706) 235-0880
Entity
Organization
Contact information
Practice address
3126 MAPLE RD SE, LINDALE, GA 30147-1307
(706) 235-0880
Mailing address
PO BOX 208, LINDALE, GA 30147-0208
(706) 235-0880
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009725
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1160693
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/02/2010
Last updated
02/04/2011
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