Jasper Drug Store At Foothills
LBN: Jasper Drug Store At Foothills
Jasper Drug Store At Foothills is an health care organization with primary practice located at 80 Foothills Pkwy , Marble Hill GA 30148-2255. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Jasper Drug Store At Foothills can be contacted via phone (770) 893-3784, or through Dunn, Lee via phone (706) 692-5910.
Contact Information
Primary practice address
80 Foothills Pkwy
Marble Hill GA 30148-2255
Phone: (770) 893-3784
Fax: (770) 893-3600
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE009465 | Georgia |
Profile Details
| NPI number | 1104083450 |
|---|---|
| LBN Legal business name | Jasper Drug Store At Foothills |
| DBA Doing business as | Jasper Drug Store At Foothills |
| Authorized official | Dunn, Lee |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 22nd, 2008 |
| Last updated | Apr 10th, 2013 - about 12 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 | 1104083450 | NPPES |
| Georgia | MEDICAID | 998025657 | |
| Georgia | Other | 2017406 |
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