Healthcare Provider Details

I. General information

NPI: 1003979626
Provider Name (Legal Business Name): K AND C PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 LEE ST
JEFFERSON GA
30549-1345
US

IV. Provider business mailing address

23 LEE ST
JEFFERSON GA
30549-1345
US

V. Phone/Fax

Practice location:
  • Phone: 706-367-5221
  • Fax: 706-367-4036
Mailing address:
  • Phone: 706-367-5221
  • Fax: 706-367-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE009101
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEITH CHAPMAN
Title or Position: PRESIDENT
Credential: RPH
Phone: 706-367-5221