Provider Demographics
NPI:1750340584
Name:LANGFORD, GEORGIE EDWARDS (RPH)
Entity type:Individual
Prefix:MRS
First Name:GEORGIE
Middle Name:EDWARDS
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WEST RAILROAD STREET
Mailing Address - Street 2:P.O. BOX 420
Mailing Address - City:SHELLMAN
Mailing Address - State:GA
Mailing Address - Zip Code:39886
Mailing Address - Country:US
Mailing Address - Phone:229-679-5070
Mailing Address - Fax:229-679-5059
Practice Address - Street 1:210 WEST RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:SHELLMAN
Practice Address - State:GA
Practice Address - Zip Code:39886
Practice Address - Country:US
Practice Address - Phone:229-679-5070
Practice Address - Fax:229-679-5059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA013175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1150705OtherNABP
GA1150705OtherNABP