Individual
LORELEI MERCEDES CHARTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
516 W HWY 80, GARDEN CITY, GA 31408-3108
(912) 966-1416
(912) 966-1417
Mailing address
PO BOX 7709, GARDEN CITY, GA 31418-7709
(912) 966-1416
(912) 966-1417
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016448
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016448
STATE LICENSE NUMBER
GA
Enumeration date
05/04/2011
Last updated
05/04/2011
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