Provider Demographics
NPI:1073558359
Name:ECONOMY DRUG CO. OF ALBANY
Entity Type:Organization
Organization Name:ECONOMY DRUG CO. OF ALBANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:229-435-5434
Mailing Address - Street 1:104 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2538
Mailing Address - Country:US
Mailing Address - Phone:229-435-5434
Mailing Address - Fax:229-432-9019
Practice Address - Street 1:104 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2538
Practice Address - Country:US
Practice Address - Phone:229-435-5434
Practice Address - Fax:229-432-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0066703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1101916OtherNABP OR NCPDP NUMBER
GA00027277AMedicaid
GA00027277BMedicaid
GA00027277BMedicaid