Provider Demographics
NPI:1588683445
Name:CHAPMAN HEALTHCARE PHARMACY INC
Entity Type:Organization
Organization Name:CHAPMAN HEALTHCARE PHARMACY INC
Other - Org Name:CHAPMAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:912-538-0053
Mailing Address - Street 1:305 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8908
Mailing Address - Country:US
Mailing Address - Phone:912-538-0053
Mailing Address - Fax:912-538-0498
Practice Address - Street 1:305 MAPLE DR.
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8908
Practice Address - Country:US
Practice Address - Phone:912-538-0053
Practice Address - Fax:912-538-0498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH011820183500000X
GARPH015706183500000X
GA3101-0010-5030-010183700000X
GA4401-0108-0562-856183700000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00869976BMedicaid
GA00869976AMedicaid
GA00869976BMedicaid