# JASPER DRUG CO INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JASPER DRUG STORE
- **Other names:** Jasper Drug Store
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700398849
- **Legal business name:** JASPER DRUG STORE
- **Authorized official:** LEE J DUNN JR. (PRESIDENT)
- **Authorized official phone:** (706) 692-6427

## Contact information

- **Practice address:** 1 N MAIN ST, JASPER, GA 30143-1500
- **Practice address phone:** (706) 692-6427
- **Mailing address:** 1 N MAIN ST, JASPER, GA 30143-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHRE006155 | GA | Yes |

## Other

- **Enumeration date:** 10/30/2017
- **Last updated:** 10/30/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00029873 | — | GA |