Provider Demographics
NPI:1366578155
Name:BIG D'S DISCOUNT DRUGS
Entity type:Organization
Organization Name:BIG D'S DISCOUNT DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:NEWTON
Authorized Official - Last Name:HOARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-775-7650
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-0005
Mailing Address - Country:US
Mailing Address - Phone:770-775-7650
Mailing Address - Fax:770-775-2715
Practice Address - Street 1:38 OAK ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-1941
Practice Address - Country:US
Practice Address - Phone:770-775-7650
Practice Address - Fax:770-775-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00911941AMedicaid
GA00911941AMedicaid