Provider Demographics
NPI:1952160962
Name:GOH, LENA QUACH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:QUACH
Last Name:GOH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:LENA
Other - Middle Name:CHEN
Other - Last Name:QUACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3595 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3152
Mailing Address - Country:US
Mailing Address - Phone:706-549-8985
Mailing Address - Fax:
Practice Address - Street 1:3595 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3152
Practice Address - Country:US
Practice Address - Phone:706-549-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist