Organization · NPI-2

Lilburn Community Pharmacy

Pharmacy, Community/Retail Pharmacy · Lilburn, GA

NPI number1134563406
StatusActive
Last updated in NPPESMay 4, 2024

Details

NPI
1134563406
Entity type
Organization (NPI-2)
Legal business name
Lilburn Community Pharmacy
Organization subpart
No
Enumeration date
Apr 17, 2013
Certification date
Feb 3, 2022
Last updated
May 4, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail PharmacyPHRE009917GAYes
333600000X Pharmacy––
3336C0004X Pharmacy, Compounding Pharmacy––
3336S0011X Pharmacy, Specialty Pharmacy––

Other names

  • Lilburn Community Pharmacy (Doing Business As)

Practice location

4025 Lawrenceville Hwy Nw Ste D
Lilburn, GA 30047-2876

Phone 770-710-0478 · Fax 770-710-0861

Mailing address

2147 Whitestone Ct Se
Smyrna, GA 30080-3116

Phone 404-909-8052

Other practice locations

325 Lester Rd Nw Ste B
Lawrenceville, GA 30044-4046

Phone 770-935-1515 · Fax 770-710-0861

Authorized official

Samina C Khatri
Owner/Organizer
7707100478

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