Provider Demographics
NPI:1346566387
Name:SOUTH ALBANY PHARMACY
Entity Type:Organization
Organization Name:SOUTH ALBANY PHARMACY
Other - Org Name:U SAVE IT PHARMACY - ADEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-435-4571
Mailing Address - Street 1:PO BOX 72148
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-2148
Mailing Address - Country:US
Mailing Address - Phone:229-435-4571
Mailing Address - Fax:229-435-4734
Practice Address - Street 1:714 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-2656
Practice Address - Country:US
Practice Address - Phone:229-896-1602
Practice Address - Fax:229-896-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0096453336C0003X, 332BC3200X, 332BX2000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA137038194AMedicaid
2124866OtherPK
6142270003Medicare NSC
6142270003Medicare NSC