Lawrence R Faulk, RPH
Individual provider Active NPI Pharmacist · Jeffersonville, GA
NPI 1609019744 · NPPES record last updated Apr 17, 2009
Key facts
- NPI
- 1609019744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018734 (GA)
- Practice address
- 2489 Hamlin Floyd Rd
Jeffersonville, GA 31044-7908 - Phone
- (478) 962-0347
- NPI assigned
- Apr 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018734 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018734 | GA | Yes |
Addresses
Primary practice location
2489 Hamlin Floyd Rd
Jeffersonville, GA 31044-7908
Mailing address
2489 Hamlin Floyd Rd
Jeffersonville, GA 31044-7908
Phone (478) 962-0347
Other providers in Jeffersonville, GA
- Ashley Elaine Boatright
- Christopher Jerry Brown
- Community Health Care Systems Inc,
- Community Health Care Systems, Inc.
- Shawonda Durham
- Her Own Incorporation
- Jeffersonville Care Center LLC
- Jeffersonville Healthcare & Rehab, LLC
- Jeffersonville Trails of Journey LLC
- Journey to Oasis Counseling and Consulting Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.