Provider Demographics
NPI:1639114200
Name:WEST DRUG CO
Entity Type:Organization
Organization Name:WEST DRUG CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEST
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:478-552-6111
Mailing Address - Street 1:102 N HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-1736
Mailing Address - Country:US
Mailing Address - Phone:478-552-6777
Mailing Address - Fax:478-552-3636
Practice Address - Street 1:102 N HARRIS ST
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-1736
Practice Address - Country:US
Practice Address - Phone:478-552-6777
Practice Address - Fax:478-552-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE005390183500000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Single Specialty