Organization
LILBURN COMMUNITY PHARMACY
Active
Other names
Lilburn Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMINA C KHATRI PHARMACY (OWNER/ORGANIZER)
(770) 710-0478
Entity
Organization
Contact information
Practice address
4025 LAWRENCEVILLE HWY NW STE D, LILBURN, GA 30047-2876
(770) 710-0478
(770) 710-0861
Mailing address
2147 WHITESTONE CT SE, SMYRNA, GA 30080-3116
(404) 909-8052
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009917
GA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133182A
—
GA
01
—
2139893
PK
—
Enumeration date
04/17/2013
Last updated
05/04/2024
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