Provider Demographics
NPI:1336979996
Name:MCCAYSVILLE DRUG CENTER INC
Entity type:Organization
Organization Name:MCCAYSVILLE DRUG CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOUSTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-492-4126
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:MC CAYSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30555-0338
Mailing Address - Country:US
Mailing Address - Phone:706-492-4126
Mailing Address - Fax:
Practice Address - Street 1:131 BLUE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MC CAYSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30555-2767
Practice Address - Country:US
Practice Address - Phone:706-492-4126
Practice Address - Fax:706-492-5902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCAYSVILLE DRUG CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy