Provider Demographics
NPI:1871639484
Name:CHASE PHARMACY INC
Entity Type:Organization
Organization Name:CHASE PHARMACY INC
Other - Org Name:CHASE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND PHCIST
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-851-1345
Mailing Address - Street 1:2700 WINCHESTER RD NE STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-9230
Mailing Address - Country:US
Mailing Address - Phone:256-851-1345
Mailing Address - Fax:256-851-1347
Practice Address - Street 1:2700 WINCHESTER RD NE STE B
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-9230
Practice Address - Country:US
Practice Address - Phone:256-851-1345
Practice Address - Fax:256-851-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1127193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995717OtherPK
AL100003664Medicaid
AL100003664Medicaid
AL6369080001Medicare NSC