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Organization

AVERA DRUG CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY ALTON SHEFFIELD PHARMACIST (PRESIDENT)
(478) 825-5561
Entity
Organization

Contact information

Practice address
111 MAIN ST, FORT VALLEY, GA 31030-3701
(478) 825-5561
(478) 825-0934
Mailing address
111 MAIN ST, FORT VALLEY, GA 31030-3701
(478) 825-5561
(478) 825-0934

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10944
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00021513A
GA
Enumeration date
03/15/2006
Last updated
08/22/2020
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