Provider Demographics
NPI:1215447586
Name:JONES AND CLAYTON DRUGS, INC
Entity type:Organization
Organization Name:JONES AND CLAYTON DRUGS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ENTREKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
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:2017-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000028223AMedicaid