Organization
LAKE PARK PHARMACY, LLC
Active
Organization
LAKE PARK PHARMACY, LLC
Active
Other names
LAKE PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY A DORMINEY PHARMD (PHARMACY MANAGER)
(229) 559-9398
Entity
Organization
Contact information
Practice address
1016 LAKES BLVD, LAKE PARK, GA 31636-3013
(229) 559-9394
(229) 559-9408
Mailing address
1016 LAKES BLVD, LAKE PARK, GA 31636-3013
(229) 559-9394
(229) 559-9408
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHRE008870
GA
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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