Clinic Drug Store, Inc.
Organization Active NPI Long Term Care Pharmacy · Americus, GA
NPI 1265985667 · NPPES record last updated Aug 2, 2016
Key facts
- NPI
- 1265985667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- PHRE003303 (GA)
- Legal business name
- CLINIC DRUG STORE, INC.
- Practice address
- 1001 E Forsyth St
Americus, GA 31709-3721 - Phone
- (229) 924-2783
- Fax
- (229) 924-9220
- NPI assigned
- Aug 2, 2016
- Organization subpart
- No
Authorized official
- Name
- Lee Pinnell
- Title
- Owner
- Phone
- (229) 942-5170
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Clinic Drug Store
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Long Term Care Pharmacy | 3336L0003X | PHRE003303 | GA | Yes |
Addresses
Primary practice location
1001 E Forsyth St
Americus, GA 31709-3721
Mailing address
PO Box 445
Americus, GA 31709-0445
Phone (229) 924-2783
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000025088A | Medicaid | GA | |
| 2162319 | Other | PK |
Other names
- CLINIC DRUG STORE
Other providers in Americus, GA
- Madison Hope Christian
- Stephanie Irene Clark
- Porsche Clayton
- Vanessa Cliatt
- Clinic Drug Store, Inc.
- Eric N Codner
- Langly Jordan Coleman
- Vickie B Collier
- Brandy Michelle Collins
- Nancy O Collins
All providers in Americus, GA · Long Term Care Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.