Provider Demographics
NPI:1639050206
Name:L M BASS LLC
Entity type:Organization
Organization Name:L M BASS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PURSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-272-8086
Mailing Address - Street 1:809 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-6305
Mailing Address - Country:US
Mailing Address - Phone:478-272-8086
Mailing Address - Fax:478-274-1171
Practice Address - Street 1:809 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-6305
Practice Address - Country:US
Practice Address - Phone:478-272-8086
Practice Address - Fax:478-274-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy