Organization
PONDER PHARMACY INC
Active
Other names
PONDER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERNIE PONDER (OWNER)
(706) 657-8100
Entity
Organization
Contact information
Practice address
11997 S MAIN ST, TRENTON, GA 30752-2855
(706) 657-8100
(706) 657-7977
Mailing address
PO BOX 849, TRENTON, GA 30752-0849
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007684
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139890
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
576815
—
GA
Enumeration date
01/23/2007
Last updated
03/20/2009
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