Organization
LELAND PHARMACY INC
Active
Other names
Mableton Pharmacy & Uniforms
Organization subpart
No
Provider details
NPI number
Authorized official
PAMALA SMITH MARQUESS (SECRETARY/TREASURER)
(770) 948-3133
Entity
Organization
Contact information
Practice address
5390 FLOYD RD SW, MABLETON, GA 30126-2216
(770) 948-3133
(770) 948-3660
Mailing address
5390 FLOYD RD SW, MABLETON, GA 30126-2216
(770) 948-3133
(770) 948-3660
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE005933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00181816A
—
GA
01
—
2139728
PK
—
Enumeration date
11/28/2006
Last updated
04/23/2013
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