Provider Demographics
NPI:1902084841
Name:DRANECO INC
Entity Type:Organization
Organization Name:DRANECO INC
Other - Org Name:ELLIJAYS BESTRX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:HOUIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRANE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-273-7879
Mailing Address - Street 1:PO BOX 993
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-0013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:763 S MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-3602
Practice Address - Country:US
Practice Address - Phone:706-273-7879
Practice Address - Fax:706-273-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-02
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0094503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1157014OtherNCPDP PROVIDER IDENTIFICATION NUMBER