Healthcare Provider Details

I. General information

NPI: 1366541203
Provider Name (Legal Business Name): WIREGRASS DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5565 HWY 43
SATSUMA AL
36572-0488
US

IV. Provider business mailing address

PO BOX 72188
ALBANY GA
31708-2188
US

V. Phone/Fax

Practice location:
  • Phone: 251-675-2070
  • Fax: 251-675-7785
Mailing address:
  • Phone: 229-435-4571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS SHARPE
Title or Position: OWNER
Credential:
Phone: 229-435-4571