Provider Demographics
NPI:1033716915
Name:AU MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:AU MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-COMMUNITY PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RASHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-522-4350
Mailing Address - Street 1:1120 15TH ST # BT2601
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:803-522-4350
Mailing Address - Fax:706-721-9505
Practice Address - Street 1:818 SAINT SEBASTIAN WAY STE 402
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2654
Practice Address - Country:US
Practice Address - Phone:706-722-4245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AU MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy