Organization
ELBEN RX INC
Active
Other names
Lawrence Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER SULLENS (PRESIDENT)
(770) 532-0186
Entity
Organization
Contact information
Practice address
631 BROAD ST SE, GAINESVILLE, GA 30501-3729
(770) 532-0186
(770) 503-1016
Mailing address
631 BROAD ST SE, GAINESVILLE, GA 30501-3729
(770) 532-0186
(770) 503-1016
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010419
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000673219A
—
GA
01
—
2174745
PK
—
Enumeration date
12/21/2017
Last updated
09/19/2025
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