Organization
LAKE PARK PHARMACY LLC
Active
Other names
CHANCY DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
HUGH CHANCY RPH (OWNER)
(229) 794-3525
Entity
Organization
Contact information
Practice address
453 LAKES BLVD, LAKE PARK, GA 31636-6607
(229) 559-9394
(229) 559-9408
Mailing address
453 LAKES BLVD, LAKE PARK, GA 31636-6607
(229) 559-9394
(229) 559-9408
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008870
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008211566B
—
GA
01
—
2015653
PK
—
Enumeration date
09/21/2006
Last updated
06/10/2015
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