Healthcare Provider Details

I. General information

NPI: 1306453428
Provider Name (Legal Business Name): CALHOUN DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 RED BUD RD NE
CALHOUN GA
30701-1959
US

IV. Provider business mailing address

630 TI PI LN
CHATSWORTH GA
30705-7786
US

V. Phone/Fax

Practice location:
  • Phone: 706-629-2426
  • Fax: 706-629-3033
Mailing address:
  • Phone: 706-260-7998
  • Fax: 706-971-3893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL BRYANT
Title or Position: OWNER
Credential: RPH
Phone: 706-260-7998