NPI | 1477657898 |
---|---|
Doing Business As | LACEY'S MARIETTA PHARMACY |
Entity Type | Organization |
Authorized Contact | LARRY L BRADEN Owner 770-974-5234 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHRE007082) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA PHRE007082) |
333600000X Pharmacy (Licence: GA PHRE007082) | |
3336C0004X Pharmacy Compounding Pharmacy (Licence: GA PHRE007082) | |
3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: GA PHRE0070082) | |
Enumeration Date | 2006-09-08 |
Last Update Date | 2019-10-08 |