Organization Name: | YE OLE DRUG SHOPPE |
NPI Number: | 1518936442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDRICK WINSTON BARBER (PRESIDENT / OWNER / PHARMACIST) |
Mailing Address: | 731 Cameron Dr Blackshear |
State: | GA US |
Postal Code: | 315161309 |
Phone Number: | 9124494444 |
Fax Number: | 9124498735 |
NPI Enumeration Date: | 03/14/2006 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |