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Contact Information

AVERA DRUG CO
111 MAIN ST
FORT VALLEY, GA31030-3701
 Phone: 478-825-5561
 Fax: 478-825-0934
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for AVERA DRUG CO

NPI # 1013986744
LBN Legal business name AVERA DRUG CO
Authorized official GARY SHEFFIELD - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/15/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
GA License # 10944
GA Medicaid 00021513A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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