1104881556 DKL31092 INC
Community/Retail Pharmacy
Active
Basic Information
- Organization Name
- DKL31092 INC
- Enumeration Date
- April 19, 2006
- Last Update
- April 21, 2010
- Authorized Official
- DONALD LANE RPH
OWNER
Phone: (478) 472-7561
Practice Location
- Address
- 112 S DOOLY ST
MONTEZUMA, GA 310631604 - Phone
- (478) 472-7561
- Fax
- (478) 472-5887
Mailing Address
- Address
- PO BOX 250
MONTEZUMA, GA 310630250 - Phone
- N/A
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Durable Medical Equipment & Medical Supplies | N/A | N/A | No |
| Long Term Care Pharmacy Long Term Care Pharmacy | 3336L0003X | Pharmacy | N/A | N/A | No |
| Pharmacy | 333600000X | Pharmacy | N/A | N/A | No |
| Community/Retail Pharmacy Community/Retail Pharmacy | 3336C0003X | Pharmacy | PHRE003393 | GA | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1112527 | 01 | N/A | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 00927649A | 05 | GA | N/A |
Frequently Asked Questions
What is DKL31092 INC's NPI number?
DKL31092 INC's NPI number is 1104881556.
Which doctor has NPI number 1104881556?
The doctor with NPI number 1104881556 is DKL31092 INC.
What is DKL31092 INC's practice address?
DKL31092 INC's practice address is 112 S DOOLY ST, MONTEZUMA, GA, 310631604.
Which doctor practices at 112 S DOOLY ST, MONTEZUMA, GA, 310631604?
DKL31092 INC practices at 112 S DOOLY ST, MONTEZUMA, GA, 310631604.
What is DKL31092 INC's mailing address?
DKL31092 INC's mailing address is PO BOX 250, MONTEZUMA, GA, 310630250.
What is DKL31092 INC's phone number?
DKL31092 INC's phone number is (478) 472-7561.
Who is (478) 472-7561?
(478) 472-7561 is the phone number for DKL31092 INC.
What is DKL31092 INC's specialty?
DKL31092 INC's specialty is Community/Retail Pharmacy.
What type of doctor is DKL31092 INC?
DKL31092 INC is a Community/Retail Pharmacy.
Is DKL31092 INC a Community/Retail Pharmacy?
Yes, DKL31092 INC is a Community/Retail Pharmacy.
Is DKL31092 INC still practicing?
Yes, DKL31092 INC is currently practicing.
Is DKL31092 INC accepting new patients?
DKL31092 INC may be accepting new patients. Please call their office at (478) 472-7561 to inquire about availability.
Is NPI 1104881556 still active?
Yes, NPI 1104881556 is currently active.
Where does DKL31092 INC practice?
DKL31092 INC practices in MONTEZUMA, GA.