Healthcare Provider Details
I. General information
NPI: 1437138377
Provider Name (Legal Business Name): WIREGRASS DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7771 HWY 43
MCINTOSH AL
36553
US
IV. Provider business mailing address
PO BOX 72188
ALBANY GA
31708-2188
US
V. Phone/Fax
- Phone: 251-944-2563
- Fax: 251-944-3080
- Phone: 229-435-4571
- Fax: 229-878-4926
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 106354 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 106354 |
| License Number State | AL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
SHARPE
Title or Position: OWNER
Credential:
Phone: 229-435-4571