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General NPI Number Information
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NPI Number | 1285849836
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Entity Type | Organization
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Legal Business Name | COMMUNITY DISCOUNT PARMACY
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 310 W GORDON AVE
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City | ALBANY
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State | GA
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Zip | 31701-3258
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Country | US
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Telephone | 229-432-7839
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Fax | 229-434-9873
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Provider Business Mailing Address
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Address Line | 310 W GORDON AVE
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City | ALBANY
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State | GA
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Zip | 31701-3258
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Country | US
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Telephone | 229-432-7839
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Fax | 229-434-9873
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Authorized Official
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Title or Position | OWNER
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Name | ANNIE RUTH BURNS
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Credential |
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Telephone | 229-435-4671
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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 | PHRE006693
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License Number State | GA
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