Provider Demographics
NPI:1396727434
Name:LEDFORDS RX EXPRESS
Entity type:Organization
Organization Name:LEDFORDS RX EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MADISON
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-638-1281
Mailing Address - Street 1:1201A N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-2150
Mailing Address - Country:US
Mailing Address - Phone:706-638-1281
Mailing Address - Fax:706-638-1283
Practice Address - Street 1:1201A N MAIN ST
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-2150
Practice Address - Country:US
Practice Address - Phone:706-638-1281
Practice Address - Fax:706-638-1283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty