Healthcare Provider Details

I. General information

NPI: 1205694908
Provider Name (Legal Business Name): PHARMACY INVESTMENT COORDINATORS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S US HIGHWAY 27
HAVANA FL
32333-2018
US

IV. Provider business mailing address

PO BOX 72188
ALBANY GA
31708-2188
US

V. Phone/Fax

Practice location:
  • Phone: 850-539-8080
  • Fax: 850-539-3050
Mailing address:
  • Phone: 229-435-4571
  • Fax: 229-878-4926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

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