Provider Demographics
NPI:1972667293
Name:FANNIN DRUGS, INC
Entity Type:Organization
Organization Name:FANNIN DRUGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:706-632-3784
Mailing Address - Street 1:2680 E FIRST ST
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4509
Mailing Address - Country:US
Mailing Address - Phone:706-632-3784
Mailing Address - Fax:706-632-3412
Practice Address - Street 1:2680 E FIRST ST
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4509
Practice Address - Country:US
Practice Address - Phone:706-632-3784
Practice Address - Fax:706-632-3412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE005386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty