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Organization
RUTLEDGE PHARMACY AND MEDICAL SUPPLIES LLC
Active
Organization
RUTLEDGE PHARMACY AND MEDICAL SUPPLIES LLC
Active
Other names
RUTLEDGE PHARMACY AND MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN IKE (PRESIDENT)
(770) 265-1740
Entity
Organization
Contact information
Practice address
2470 LEONE AVE STE E, LOGANVILLE, GA 30052-6147
(770) 728-9624
(770) 728-9729
Mailing address
2470 LEONE AVE, SUITE E, LOGANVILLE, GA 30052-6169
(770) 728-9624
(770) 728-9729
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009924
GA
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
05/21/2013
Last updated
06/19/2014
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