Individual
BENJAMIN LAKE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
240 MILLEDGEVILLE HWY, GORDON, GA 31031-3827
(478) 628-2481
(478) 628-2263
Mailing address
240 MILLEDGEVILLE HWY, P.O. BOX 249, GORDON, GA 31031-3827
(478) 628-2481
(478) 628-2263
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025078
GA
183500000X
Pharmacist
20457
NC
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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