Provider Information for 1922117282
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LOVVORN DRUG COMPANY LLC
Other Names:Doing Business As:LOVVORN DRUG COMPANY LLCOrganization Subpart: NO
NPI: 1922117282
Last Updated: 2021-11-22
Certification Date: 2021-11-22
Certification Date: 2021-11-22
Details
Name | Value | ||||||||||||
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NPI | 1922117282 | ||||||||||||
Enumeration Date | 2006-08-30 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: Dr. BRANDALL S LOVVORN PHARM.D Title: OWNER/PHARMACIST Phone: 7705378889 | ||||||||||||
Mailing Address | PO BOX 603 BREMEN, GA 30110-0603 United States Phone: 770-537-8889 | Fax:770-537-8817 | ||||||||||||
Primary Practice Address | 404 ALABAMA AVE S BREMEN, GA 30110-2006 United States Phone: 770-537-8889 | Fax:770-537-8817 | ||||||||||||
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