Provider Demographics
NPI:1548310535
Name:LUDOWICI DRUGS
Entity type:Organization
Organization Name:LUDOWICI DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNS
Authorized Official - Middle Name:STANFORD
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:912-545-2125
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-0190
Mailing Address - Country:US
Mailing Address - Phone:912-545-2125
Mailing Address - Fax:
Practice Address - Street 1:1 CYPRESS STREET
Practice Address - Street 2:
Practice Address - City:LUDOWICI
Practice Address - State:GA
Practice Address - Zip Code:31316-0190
Practice Address - Country:US
Practice Address - Phone:912-545-2125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE007410333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00507999AMedicaid
GA1137858OtherNABP