Provider Demographics
NPI:1861711202
Name:A & D PHARMACY, LLC
Entity type:Organization
Organization Name:A & D PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-783-1515
Mailing Address - Street 1:P O BOX 1412
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-0000
Mailing Address - Country:US
Mailing Address - Phone:478-783-1515
Mailing Address - Fax:478-783-1404
Practice Address - Street 1:342 INDUSTRIAL BOULEVARD
Practice Address - Street 2:SUITE E
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-0000
Practice Address - Country:US
Practice Address - Phone:478-783-1515
Practice Address - Fax:478-783-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPPLIED FOR183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty