Provider Demographics
NPI:1376759373
Name:DUNAHOO DRUGS
Entity Type:Organization
Organization Name:DUNAHOO DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:DUNAHOO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:770-867-3500
Mailing Address - Street 1:35 W MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2564
Mailing Address - Country:US
Mailing Address - Phone:770-867-3500
Mailing Address - Fax:770-867-3566
Practice Address - Street 1:35 W MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2564
Practice Address - Country:US
Practice Address - Phone:770-867-3500
Practice Address - Fax:770-867-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6215740001OtherMEDICARE PART A PART B
GA924421522AMedicaid