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Organization
COMMUNITY ANCILLARY SERVICES, INC.
Active
Organization
COMMUNITY ANCILLARY SERVICES, INC.
Active
Other names
Eldercare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RUSTY LEE JR. RPH (SENIOR VICE PRESIDENT)
(478) 783-1515
Entity
Organization
Contact information
Practice address
342 INDUSTRIAL BLVD, SUITE A, HAWKINSVILLE, GA 31036-2106
(478) 783-1515
(478) 783-1404
Mailing address
PO BOX 997, HAWKINSVILLE, GA 31036-0997
(478) 783-1515
(478) 783-1404
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00377858A
—
GA
05
—
00377858B
—
GA
01
—
1135359
NCPDP
GA
Enumeration date
08/19/2005
Last updated
03/11/2021
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