Organization
LIFECARE PHARMACY GA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIJESH BHAGAT (CEO)
(706) 850-2133
Entity
Organization
Contact information
Practice address
130 GAINS SCHOOL RD, ATHENS, GA 30605
(706) 850-2133
Mailing address
130 GAINES SCHOOL RD, ATHENS, GA 30605-3118
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010376
GA
Other
Enumeration date
08/22/2017
Last updated
02/03/2018
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