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General NPI Number Information
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NPI Number | 1346566387
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Entity Type | Organization
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Legal Business Name | SOUTH ALBANY PHARMACY LLC
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 714 W 4TH ST
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City | ADEL
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State | GA
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Zip | 31620-2656
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Country | US
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Telephone | 229-896-1602
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Fax | 229-896-1621
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Provider Business Mailing Address
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Address Line | PO BOX 72148
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City | ALBANY
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State | GA
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Zip | 31708-2148
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Country | US
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Telephone | 229-435-4571
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Fax | 229-435-4734
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THOMAS SHARPE
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Credential |
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Telephone | 229-435-4571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE009645
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License Number State | GA
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