Provider Demographics
NPI:1649336421
Name:AVERY DRUGS INC.
Entity type:Organization
Organization Name:AVERY DRUGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERSCHEL
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-291-0999
Mailing Address - Street 1:710 N 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2704
Mailing Address - Country:US
Mailing Address - Phone:706-291-0999
Mailing Address - Fax:706-291-2558
Practice Address - Street 1:710 N 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2704
Practice Address - Country:US
Practice Address - Phone:706-291-0999
Practice Address - Fax:706-291-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA3954630001Medicare NSC