Provider Demographics
NPI:1962463711
Name:LUREY, JEFFREY LEWIS (RPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEWIS
Last Name:LUREY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 JUDITH WAY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-2905
Mailing Address - Country:US
Mailing Address - Phone:404-848-1590
Mailing Address - Fax:404-237-8435
Practice Address - Street 1:1082 JUDITH WAY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-2905
Practice Address - Country:US
Practice Address - Phone:404-848-1590
Practice Address - Fax:404-237-8435
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist