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CANDACE LANE ALTMAN

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1790311785

Individual Registrant:
 CANDACE LANE ALTMAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
546 W BACON ST  PEMBROKE, GA 31321-4648 US
Tel: 912-653-1000  Fax: 912-295-4667

Contact information for business:
546 W BACON ST  PEMBROKE, GA 31321-4648 US
Tel: 912-653-1000  Fax: 912-295-4667

Registration Information:
NPI: 1790311785
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GARPH031811

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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