MEDICARE: PHARMACY INVESTMENT COORDINATORS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH22879	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2007895	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063577260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY INVESTMENT COORDINATORS INC

Provider Business Mailing Address
First Line	:	PO BOX 72148
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31708-2148
Country	:	US
Telephone Number	:	229-435-4571
Fax Number	:	229-435-4734

Provider Business Practice Location Address
First Line	:	218 S HIGHWAY 71
Second Line	:
City	:	WEWAHITCHKA
State	:	FL
Zip	:	32465-4305
Country	:	US
Telephone Number	:	850-639-5065
Fax Number	:	850-639-4077

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS SHARPE
Credential	:
Telephone Number	:	229-435-4571

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	11/18/2021

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