Organization
LANIER PHARMACY, LLC
Active
Other names
Lanier Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL CROW (RPH/OWNER)
(770) 536-8861
Entity
Organization
Contact information
Practice address
3560 THOMPSON BRIDGE RD, GAINESVILLE, GA 30506-1518
(770) 536-8861
(770) 503-1201
Mailing address
3560 THOMPSON BRIDGE RD, GAINESVILLE, GA 30506-1518
(770) 536-8861
(770) 503-1201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010420
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000673208A
—
GA
01
—
2175196
PK
—
Enumeration date
12/22/2017
Last updated
07/19/2018
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