Healthcare Provider Details

I. General information

NPI: 1003922600
Provider Name (Legal Business Name): PHARMACY INVESTMENT COORDINATORS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E BROAD ST
EUFAULA AL
36027-2024
US

IV. Provider business mailing address

PO BOX 72188
ALBANY GA
31708-2188
US

V. Phone/Fax

Practice location:
  • Phone: 334-687-3591
  • Fax: 334-687-5466
Mailing address:
  • Phone: 334-687-3591
  • Fax: 334-687-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number009953285
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRACY C ALLIGOOD
Title or Position: CEO
Credential:
Phone: 229-435-4571