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General NPI Number Information
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NPI Number | 1528478328
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Entity Type | Organization
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Legal Business Name | CLEVELAND DRUG CO INC
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 184 WEST KYTLE STREET SUITE A
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City | CLEVELAND
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State | GA
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Zip | 30528
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Country | US
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Telephone | 706-219-2626
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Fax | 706-219-1253
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Provider Business Mailing Address
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Address Line | 184 WEST KYTLE STREET SUITE A
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City | CLEVELAND
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State | GA
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Zip | 30528
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Country | US
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Telephone | 706-219-2626
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Fax | 706-219-1253
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Authorized Official
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Title or Position | REGISTERED PHARMACIST/CO-OWNER
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Name | MRS. HALEY THOMAS
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Credential | PHARMD
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Telephone | 706-219-2626
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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 | GA
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