Provider Demographics
NPI:1235393331
Name:HUDSON, LAUREN COLE
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:COLE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 AYLESBURY LN
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-9101
Mailing Address - Country:US
Mailing Address - Phone:706-614-3361
Mailing Address - Fax:
Practice Address - Street 1:2350 N COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2091
Practice Address - Country:US
Practice Address - Phone:478-414-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51446183500000X
GARPH024088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist