Organization
BENZER PHARMACY GA1 LLC
Active
Other names
The Pharmacy at Lake Oconee
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT STINSON (OWNER)
(678) 521-3820
Entity
Organization
Contact information
Practice address
1031 VILLAGE PARK DR STE 104, GREENSBORO, GA 30642-3755
(706) 999-9792
(706) 999-9795
Mailing address
1031 VILLAGE PARK DR STE 104, GREENSBORO, GA 30642-3755
(706) 999-9792
(706) 999-9795
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010342
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165802
PK
—
Enumeration date
05/22/2015
Last updated
07/19/2018
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