Provider Demographics
NPI:1295829885
Name:PRICE RINGGOLD DRUG INC
Entity Type:Organization
Organization Name:PRICE RINGGOLD DRUG INC
Other - Org Name:PRICE RINGGOLD DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:706-866-8475
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-0339
Mailing Address - Country:US
Mailing Address - Phone:706-935-3131
Mailing Address - Fax:706-965-7036
Practice Address - Street 1:7566 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2361
Practice Address - Country:US
Practice Address - Phone:706-935-3131
Practice Address - Fax:706-965-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0027693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00033679AMedicaid
2012756OtherPK