Montezuma Drug Company
LBN: Dkl31092 Inc
Montezuma Drug Company is an health care organization with primary practice located at 112 S Dooly St , Montezuma GA 31063-1604. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Dkl31092 Inc can be contacted via phone (478) 472-7561, or through Lane, Donald via phone (478) 472-7561.
Contact Information
Primary practice address
112 S Dooly St
Montezuma GA 31063-1604
Phone: (478) 472-7561
Fax: (478) 472-5887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE003393 | Georgia |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1104881556 |
|---|---|
| LBN Legal business name | Dkl31092 Inc |
| DBA Doing business as | Montezuma Drug Company |
| Authorized official | Lane, Donald RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Apr 21st, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104881556 | NPPES |
| Other | 1112527 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 00927649A | NCPDP PROVIDER IDENTIFICATION NUMBER |
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