MEDICARE: MEDICAL ARTS

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	5354	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5354	OTHER	GA	STATE LICENCE #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265437768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL ARTS

Provider Business Mailing Address
First Line	:	205B E MAIN ST
Second Line	:
City	:	HAHIRA
State	:	GA
Zip	:	31632-1121
Country	:	US
Telephone Number	:	229-794-3525
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 N HUTCHINSON AVE
Second Line	:
City	:	ADEL
State	:	GA
Zip	:	31620-2344
Country	:	US
Telephone Number	:	229-896-4564
Fax Number	:

Authorized Official
Title or Position	:	R.PH.
Name	:	HUGH M CHANCY
Credential	:
Telephone Number	:	229-896-4564

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	05/20/2024

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Directions to “MEDICAL ARTS ” Practice Location

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