Organization
SOUTHERN CRESCENT PHARMACY INC
Active
Other names
LAMBERT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA BONNER (PRESIDENT)
(770) 463-4031
Entity
Organization
Contact information
Practice address
405 CARLTON RD, PALMETTO, GA 30268-1052
(770) 463-4031
(770) 463-4946
Mailing address
PO BOX 1549, PALMETTO, GA 30268-7549
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008980
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00247277A
—
GA
01
—
1126906
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/06/2006
Last updated
03/16/2011
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