Provider Demographics
NPI:1033522644
Name:DOLLAR PRESCRIPTION SHOP TOO
Entity Type:Organization
Organization Name:DOLLAR PRESCRIPTION SHOP TOO
Other - Org Name:JS HOLDING
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:BINION
Authorized Official - Last Name:KETCHEM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:770-445-5974
Mailing Address - Street 1:537 HARDEE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-4711
Mailing Address - Country:US
Mailing Address - Phone:770-445-5974
Mailing Address - Fax:770-445-7487
Practice Address - Street 1:2151 CEDARCREST RD
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101
Practice Address - Country:US
Practice Address - Phone:770-445-0976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy