Organization
ELBERTON PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES MAXWELL THOMAS RPH (OWNER)
(706) 283-3161
Entity
Organization
Contact information
Practice address
556 ELBERT ST, ELBERTON, GA 30635-2347
(706) 283-3161
(706) 283-3728
Mailing address
556 ELBERT ST, ELBERTON, GA 30635-2347
(706) 283-3161
(706) 283-3728
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE006440
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000027398A
—
GA
Enumeration date
02/17/2007
Last updated
01/05/2011
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