Lee Goodrum Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE006304 Issued in GA

Legal business name

LEE GOODRUM PHARMACY INC

Doing business as

LEE GOODRUM PHARMACY

Practice address

40 Hospital Rd
Newnan, GA 30263-1201

Phone

(770) 253-1121

Fax

(770) 253-3572

NPI assigned

Jul 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Goodrum, BS PHARMACY

Title

Ceo

Phone

(770) 253-1121

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LEE GOODRUM PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1053332015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631201",
            "telephone_number": "770-253-1121",
            "fax_number": "770-253-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631201",
            "telephone_number": "770-253-1121",
            "fax_number": "770-253-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE GOODRUM PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "GOODRUM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-253-1121",
        "authorized_official_credential": "BS PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE006304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00285051A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014853",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEE GOODRUM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Hale Lawson, CRNA
• Brittany Lear, RD LD
• Katlyn Michelle Leblanc, DPT, PT
• Quianna Leblanc, MSN, APRN, FNP-C
• Lee and Lee Inc
• Tiara Lee-Harrington
• Hye Soo Lee
• Laura Mae Lee, CRNA
• Mariah Lee, BCBA
• Sojeong Lee

• Community/Retail Pharmacy in Newnan, GA
• Providers in Newnan, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.