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HAROLD NEAL FORENCE
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1629182530
Individual Registrant: HAROLD NEAL FORENCE
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
324 W PATTON ST LA FAYETTE, GA 30728-0791 US
Tel: 706-638-3114 Fax: 706-638-7713
Tel: 706-638-3114 Fax: 706-638-7713
Contact information for business:
PO BOX 791 LA FAYETTE, GA 30728-0791 US
Tel: 706-638-3114 Fax: 706-638-7713
Tel: 706-638-3114 Fax: 706-638-7713
Registration Information:
NPI: 1629182530
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | GA | 11913 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
