Healthcare Provider Details

I. General information

NPI: 1245675073
Provider Name (Legal Business Name): UNADILLA DRUG COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 SECOND ST
UNADILLA GA
31091
US

IV. Provider business mailing address

PO BOX 14
UNADILLA GA
31091-0014
US

V. Phone/Fax

Practice location:
  • Phone: 478-627-3041
  • Fax: 478-627-3874
Mailing address:
  • Phone: 478-627-3041
  • Fax: 478-627-3874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE009921
License Number StateGA

VIII. Authorized Official

Name: DHARA PATEL
Title or Position: PHARMACY MANAGER
Credential:
Phone: 478-627-3041