# COMMUNITY ANCILLARY SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eldercare Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235121617
- **Authorized official:** JAMES LEE (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (478) 783-1515

## Contact information

- **Practice address:** 4769 S MAIN ST, ACWORTH, GA 30101-5339
- **Practice address phone:** (770) 974-4277
- **Practice address fax:** (770) 974-4208
- **Mailing address:** PO BOX 1038, ACWORTH, GA 30101-8938
- **Mailing address phone:** (770) 974-4277
- **Mailing address fax:** (770) 974-4208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PHRE008075 | GA | Yes |

## Other

- **Enumeration date:** 08/22/2005
- **Last updated:** 03/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00811478A | — | GA |
| 01 | — | 2020178 | PK | — |