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General NPI Number Information
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NPI Number | 1275692683
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Entity Type | Organization
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Legal Business Name | ANGLIN'S DRUG STORE, INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 85 E MAIN ST
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City | BUFORD
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State | GA
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Zip | 30518-5712
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Country | US
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Telephone | 770-945-9501
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Fax | 770-932-6169
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | BUFORD
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State | GA
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Zip | 30515-0547
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Country | US
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Telephone | 770-945-9501
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Fax | 770-932-6169
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. WILLIAM A ANGLIN
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Credential | RPH
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Telephone | 770-945-9501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE002235
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License Number State | GA
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