Provider Demographics
NPI:1336744226
Name:WEBB, LUCYNA ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LUCYNA
Middle Name:ANNE
Last Name:WEBB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LUCYNA
Other - Middle Name:ANNE
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:887 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3900
Mailing Address - Country:US
Mailing Address - Phone:706-618-2568
Mailing Address - Fax:
Practice Address - Street 1:887 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3900
Practice Address - Country:US
Practice Address - Phone:706-861-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UNKNOWNOtherUNKNOWN