Provider Demographics
NPI:1720175342
Name:JONES AND CLAYTON DRUGS, INC
Entity Type:Organization
Organization Name:JONES AND CLAYTON DRUGS, INC
Other - Org Name:GARRETT DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:ENTREKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, CDM
Authorized Official - Phone:770-537-2364
Mailing Address - Street 1:116 BUCHANAN ST N
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-1606
Mailing Address - Country:US
Mailing Address - Phone:770-537-2364
Mailing Address - Fax:770-537-3032
Practice Address - Street 1:116 BUCHANAN ST N
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-1606
Practice Address - Country:US
Practice Address - Phone:770-537-2364
Practice Address - Fax:770-537-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE005152332B00000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00028223BMedicaid
GA00028223BMedicaid