Dkl31092 INC

NPI #1104881556 in Montezuma, Georgia

Provider Information

NPI Number
1104881556
Entity Type
Organization
Organization Name
Dkl31092 INC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Apr 19, 2006
Last Updated
Apr 21, 2010

Practice Location

Address
112 S DOOLY ST
State
Georgia
ZIP Code
31063-1604
Phone
(478) 472-7561

Authorized Official

Name
DONALD LANE, RPH
Title
OWNER
Phone
(478) 472-7561

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Long Term Care PharmacyLong Term Care Pharmacy
Pharmacy
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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