Clayton Pharmacy

LBN: Self-Med Rx Clayton Drug Inc
Clayton Pharmacy is an health care organization with primary practice located at 100 S Main St , Clayton GA 30525-5480. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Self-Med Rx Clayton Drug Inc can be contacted via phone (706) 782-3211, or through Addington, Mike via phone (706) 782-3211.

Contact Information

Primary practice address
100 S Main St Clayton GA 30525-5480
Fax: (706) 782-0705
Website:
Authorized official contact:
Name: Addington, Mike

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE002710 Georgia
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1285722710
LBN Legal business name Self-Med Rx Clayton Drug Inc
DBA Doing business as Clayton Pharmacy
Authorized official Addington, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated Apr 1st, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285722710 NPPES
Georgia MEDICAID 00025033A
Georgia Other 2012111

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