Organization
RR LONG INC
Active
Other names
JACKSON DRUG CO
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY HOGAN RPH (OWNER AND PRESIDENT)
(770) 775-7880
Entity
Organization
Contact information
Practice address
4 2ND ST, JACKSON, GA 30233-1920
(770) 775-7880
(770) 775-1279
Mailing address
PO BOX 125, JACKSON, GA 30233-0004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE004185
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00029807A
—
GA
05
—
1110903
—
GA
01
—
2012451
PK
—
Enumeration date
06/15/2006
Last updated
07/01/2013
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