Ledford RX Express Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009565 Issued in GA

Legal business name

LEDFORD RX EXPRESS INC

Practice address

103 Highway 48
Summerville, GA 30747-1506

Phone

(706) 857-3300

Fax

(706) 857-3303

NPI assigned

Nov 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dwight Harper

Title

Ceo / Owner

Phone

(706) 857-3300

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ledfords Rx Pharmacy 2 Doing business as

Tax ID family

Ledford RX Express Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ledford RX Express Inc

  • Long Term Care Pharmacy
  • La Fayette, GA
  • NPI 1275458754
  NPD tax ID
• Ledfords RX Express

  • Pharmacist
  • La Fayette, GA
  • NPI 1396727434
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1730369752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 HIGHWAY 48",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471506",
            "telephone_number": "706-857-3300",
            "fax_number": "706-857-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 HIGHWAY 48",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471506",
            "telephone_number": "706-857-3300",
            "fax_number": "706-857-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEDFORD RX EXPRESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "CEO / OWNER",
        "authorized_official_telephone_number": "706-857-3300"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1115080",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00209921A4",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176262796B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ledfords Rx Pharmacy 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Key, COTA/L
• Luanne Thomas Kilgo, OTR/L
• Weston King, M.D.
• Lisa Renee Kirkpatrick, MS, OTR/L
• Sonya Meleia Koshute, PTA
• Lookout Mountain Community Service
• Lookout Mountain Community Service
• Lookout Mountain Community Service
• Lookout Mountain Community Services
• Lookout Mountain Community Services

• All providers in Summerville, GA
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.