Organization
KENWOOD PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORREN BARTHOLOMEW (GENERAL MGR)
(770) 231-1616
Entity
Organization
Contact information
Practice address
101 KENWOOD RD, STE 28, FAYETTEVILLE, GA 30214-3459
(770) 460-1065
(770) 460-1066
Mailing address
101 KENWOOD RD, STE 28, FAYETTEVILLE, GA 30214-3459
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHRE009020
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154359
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
09/11/2025
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