Healthcare Provider Details

I. General information

NPI: 1639441983
Provider Name (Legal Business Name): ALLCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S OXLEY DR
LYONS GA
30436-5645
US

IV. Provider business mailing address

112 S OXLEY DR
LYONS GA
30436-5645
US

V. Phone/Fax

Practice location:
  • Phone: 912-526-3200
  • Fax: 912-526-9199
Mailing address:
  • Phone: 912-526-3200
  • Fax: 912-526-9199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHRE008278
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHRE008278
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHRE008278
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHRE008278
License Number StateGA

VIII. Authorized Official

Name: ROBERT T DRIGGERS
Title or Position: PRESIDENT
Credential: R.PH
Phone: 912-526-3200