Provider Demographics
NPI:1508636622
Name:MCRAES PHARMACY OF DOUGLAS INC
Entity Type:Organization
Organization Name:MCRAES PHARMACY OF DOUGLAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:912-384-5255
Mailing Address - Street 1:1002 WARD ST W
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2251
Mailing Address - Country:US
Mailing Address - Phone:912-384-5255
Mailing Address - Fax:912-383-7128
Practice Address - Street 1:1002 WARD ST W
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2251
Practice Address - Country:US
Practice Address - Phone:912-384-5255
Practice Address - Fax:912-383-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy