Organization
BENNETT DRUG COMPANY
Active
Other names
BENNETT DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BENNETT (OWNER)
(229) 468-7479
Entity
Organization
Contact information
Practice address
207 E 4TH ST, OCILLA, GA 31774-1540
(229) 468-7478
(229) 468-7479
Mailing address
207 E 4TH ST, OCILLA, GA 31774-1540
(229) 468-7478
(229) 468-7479
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE005409
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021887A
—
GA
01
—
1112767
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/11/2006
Last updated
10/18/2011
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