Provider Demographics
NPI:1164058566
Name:ABBOTT, LAUREN LINDSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LINDSEY
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:OMEGA
Mailing Address - State:GA
Mailing Address - Zip Code:31775-0098
Mailing Address - Country:US
Mailing Address - Phone:229-528-4276
Mailing Address - Fax:
Practice Address - Street 1:246 OAK ST
Practice Address - Street 2:
Practice Address - City:OMEGA
Practice Address - State:GA
Practice Address - Zip Code:31775-3087
Practice Address - Country:US
Practice Address - Phone:229-528-4276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist