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General NPI Number Information
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NPI Number | 1972667293
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Entity Type | Organization
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Legal Business Name | FANNIN DRUGS, INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2680 E FIRST ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4509
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Country | US
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Telephone | 706-632-3784
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Fax | 706-632-3412
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Provider Business Mailing Address
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Address Line | 2680 E FIRST ST
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City | BLUE RIDGE
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State | GA
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Zip | 30513-4509
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Country | US
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Telephone | 706-632-3784
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Fax | 706-632-3412
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Authorized Official
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Title or Position | PRES
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Name | MR. RONALD D GILLESPIE
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Credential | RPH
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Telephone | 706-632-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHRE005386
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License Number State | GA
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