Organization
CLARKESVILLE DRUG COMPOUNDING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LEDBETTER (OWNER/PHARMACIST)
(706) 754-3763
Entity
Organization
Contact information
Practice address
596 W LOUISE ST, CLARKESVILLE, GA 30523-5849
(706) 754-3763
(706) 839-1293
Mailing address
596 W LOUISE ST, CLARKESVILLE, GA 30523-5849
(706) 754-3763
(706) 839-1293
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHRE009524
GA
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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