Organization
JASPER DRUG CO INC
Active
Parent organization
JASPER DRUG STORE
Other names
Jasper Drug Store
Organization subpart
Yes
Provider details
NPI number
Legal business name
JASPER DRUG STORE
Authorized official
LEE J DUNN JR. (PRESIDENT)
(706) 692-6427
Entity
Organization
Contact information
Practice address
1 N MAIN ST, JASPER, GA 30143-1500
(706) 692-6427
Mailing address
1 N MAIN ST, JASPER, GA 30143-1500
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHRE006155
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00029873
—
GA
Enumeration date
10/30/2017
Last updated
10/30/2017
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