Organization
TOWNE LAKE FAMILY PHARMACY LLC
Active
Other names
Towne lake Family Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
OFORI QUARCOO (OWNER)
(770) 635-7697
Entity
Organization
Contact information
Practice address
2360 TOWNE LAKE PKWY STE 102, WOODSTOCK, GA 30189-5576
(770) 635-7697
(770) 635-7526
Mailing address
2360 TOWNE LAKE PKWY STE 102, WOODSTOCK, GA 30189-5576
(770) 635-7697
(770) 635-7526
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009746
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109334A
—
GA
01
—
2130061
PK
—
Enumeration date
04/21/2011
Last updated
04/20/2023
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