Organization
COMMUNITY ANCILLARY SERVICES, INC.
Active
Other names
Eldercare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RUSTY LEE JR. RPH (SENIOR VICE PRESIDENT)
(478) 783-1515
Entity
Organization
Contact information
Practice address
342 INDUSTRIAL BLVD, SUITE A, HAWKINSVILLE, GA 31036-2106
(478) 783-1515
(478) 783-1404
Mailing address
PO BOX 997, HAWKINSVILLE, GA 31036-0997
(478) 783-1515
(478) 783-1404
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00377858A
—
GA
05
—
00377858B
—
GA
01
—
1135359
NCPDP
GA
Enumeration date
08/19/2005
Last updated
03/11/2021
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