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General NPI Number Information
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NPI Number | 1235277021
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Entity Type | Organization
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Legal Business Name | CWG INVESTMENTS
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 500 W GORDON ST
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City | THOMASTON
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State | GA
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Zip | 30286-3415
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Country | US
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Telephone | 706-647-8965
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Fax | 706-647-4529
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Provider Business Mailing Address
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Address Line | 500 W GORDON ST
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City | THOMASTON
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State | GA
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Zip | 30286-3415
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Country | US
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Telephone | 706-647-8965
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Fax | 706-647-4529
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARSON GLEATON
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Credential | PHARMD
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Telephone | 706-647-8965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 005707
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License Number State | GA
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