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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