Provider Demographics
NPI:1982742300
Name:CHAPMAN DRUG CO., INC.
Entity Type:Organization
Organization Name:CHAPMAN DRUG CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:404-761-1136
Mailing Address - Street 1:615 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1917
Mailing Address - Country:US
Mailing Address - Phone:404-761-1136
Mailing Address - Fax:404-761-1711
Practice Address - Street 1:615 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1917
Practice Address - Country:US
Practice Address - Phone:404-761-1136
Practice Address - Fax:404-761-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0009003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHRE000900OtherSTATE LICENSE #
GA00023075AMedicaid
GA00023075AMedicaid
GAPHRE000900OtherSTATE LICENSE #