MEDICARE: MR. CHARLES MALCOLM WOODRUFF RPH

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	183500000X	Pharmacist	RPH010104	GA

General Provider Information

NPI Number	:	1235461435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES MALCOLM WOODRUFF RPH

Provider Business Mailing Address
First Line	:	2525 DAWSON RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2315
Country	:	US
Telephone Number	:	229-435-5646
Fax Number	:	229-432-5363

Provider Business Practice Location Address
First Line	:	2525 DAWSON RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2315
Country	:	US
Telephone Number	:	229-435-5646
Fax Number	:	229-432-5363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2010
Last Update Date	:	02/15/2026

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