Organization
GARDEN LAKES PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L HENDERSON RPH (OWNER PHARMACIST)
(706) 378-7945
Entity
Organization
Contact information
Practice address
2022 REDMOND CIR NW, ROME, GA 30165-1322
(706) 378-7945
(706) 378-7949
Mailing address
2022 REDMOND CIR NW, ROME, GA 30165-1322
(706) 378-7945
(706) 378-7949
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE008455
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00886916A
—
GA
Enumeration date
02/28/2007
Last updated
08/22/2020
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