Organization
TARRYTOWN EXPOCARE GA, INC.
Active
Other names
Tarrytown Expocare GA, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LASHLEY (CEO)
(855) 617-7312
Entity
Organization
Contact information
Practice address
953 BRANCH CT, GROVETOWN, GA 30813-3325
(706) 595-4840
(706) 595-8665
Mailing address
8500 SHOAL CREEK BLVD BLDG 1, AUSTIN, TX 78757-6888
(512) 617-7312
(512) 617-7313
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHRE009461
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016907
PK
—
Enumeration date
03/18/2008
Last updated
08/07/2024
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