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General NPI Number Information
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NPI Number | 1396093381
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Entity Type | Organization
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Legal Business Name | LEDFORDS RX EXPRESS PHARMACY
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Dates
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Enumeration Date | 08/22/2012
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Last Update Date | 08/22/2012
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Provider Practice Location Address
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Address Line | 1201 N MAIN ST
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City | LA FAYETTE
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State | GA
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Zip | 30728-2150
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Country | US
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Telephone | 706-638-1281
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Fax | 706-638-1283
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Provider Business Mailing Address
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Address Line | 1201 N MAIN ST
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City | LA FAYETTE
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State | GA
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Zip | 30728-2150
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Country | US
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Telephone | 706-638-1281
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Fax | 706-638-1283
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MADISON LEDFORD
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Credential |
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Telephone | 706-638-1281
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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 | PHRE008978
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License Number State | GA
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