Ledford RX Express Inc

Organization Active NPI Community/Retail Pharmacy · La Fayette, GA

NPI 1376652099 · NPPES record last updated Apr 22, 2026

Key facts

NPI
1376652099
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHRE008978 (GA)
Legal business name
LEDFORD RX EXPRESS INC
Practice address
1201 N Main St
La Fayette, GA 30728-2150
Phone
(706) 638-1281
Fax
(706) 638-1283
NPI assigned
Aug 29, 2006
Organization subpart
No

Authorized official

Name
Lora Hutcherson, PHARM.D
Title
Owner/Pic
Phone
(706) 638-1281

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20121231000093 GA Part B Supplier - Mass Immunization (Roster Biller Only) 5193926855 1 other NPI on this enrollment
Practice locations: La Fayette, GA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE008978 GA Yes

Addresses

Primary practice location

1201 N Main St
La Fayette, GA 30728-2150

Mailing address

1201 N Main St
La Fayette, GA 30728-2150
Phone (706) 638-1281

Other identifiers

IdentifierTypeStateIssuer
179262796AMedicaidGA
1153751OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names

  • Ledford Rx Express Pharmacy Doing business as

Other providers in La Fayette, GA

All providers in La Fayette, GA · Community/Retail Pharmacy in Georgia

Sources for this page

Verify at the official NPI Registry.