Organization
MADISON DRUG LLC
Active
Other names
Madison Drug
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI MICHELLE BASS PHARM D (PIC)
(706) 342-1722
Entity
Organization
Contact information
Practice address
213 N. MAIN ST, MADISON, GA 30650-1312
(706) 342-1722
(706) 342-3277
Mailing address
P.O. BOX 1266, MADISON, GA 30650
(706) 342-1722
(706) 342-3277
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006020
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031215A
—
GA
01
—
2012577
PK
—
Enumeration date
08/27/2006
Last updated
06/09/2025
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