Organization Name: | EAGLE'S LANDING PHARMACY |
NPI Number: | 1417081001 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID THOMAS RINK (PRESIDENT) |
Mailing Address: | 1090 Eagles Landing Pkwy Stockbridge |
State: | GA US |
Postal Code: | 302815012 |
Phone Number: | 7704745005 |
Fax Number: | 7704748093 |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | PHRE007404 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |