Organization
A CARTER CLEMENTS JR
Active
Other names
ABBEVILLE DISCOUNT DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
CARTER CLEMENTS (OWNER)
(229) 385-5351
Entity
Organization
Contact information
Practice address
201 MAIN ST W, ABBEVILLE, GA 31001-4211
(229) 467-2221
(229) 467-2089
Mailing address
PO BOX 427, ABBEVILLE, GA 31001-0427
(229) 467-2221
(229) 467-2087
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009470
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00021007A
—
GA
01
—
2016364
PK
—
Enumeration date
03/04/2008
Last updated
06/17/2016
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