Provider Demographics
NPI:1235277021
Name:CWG INVESTMENTS
Entity Type:Organization
Organization Name:CWG INVESTMENTS
Other - Org Name:THOMASTON PRESCRIPTION SHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEATON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:706-647-8965
Mailing Address - Street 1:500 W GORDON ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3415
Mailing Address - Country:US
Mailing Address - Phone:706-647-8965
Mailing Address - Fax:706-647-4529
Practice Address - Street 1:500 W GORDON ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3415
Practice Address - Country:US
Practice Address - Phone:706-647-8965
Practice Address - Fax:706-647-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GA0057073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1115953OtherNCPDP PROVIDER IDENTIFICATION NUMBER
GA892288457AMedicaid
1115953OtherNCPDP PROVIDER IDENTIFICATION NUMBER