MEDICARE: WIREGRASS DRUGS 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	332B00000X	Durable Medical Equipment & Medical Supplies	106354	AL
2	332BX2000X	Oxygen Equipment & Supplies (DME)	106354	AL
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510-54843	OTHER		BLUE CROSS BLUE SHIELD DME
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437138377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIREGRASS DRUGS INC

Provider Business Mailing Address
First Line	:	PO BOX 72188
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31708-2188
Country	:	US
Telephone Number	:	229-435-4571
Fax Number	:	229-878-4926

Provider Business Practice Location Address
First Line	:	7771 HWY 43
Second Line	:
City	:	MCINTOSH
State	:	AL
Zip	:	36553
Country	:	US
Telephone Number	:	251-944-2563
Fax Number	:	251-944-3080

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	02/05/2025

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Directions to “WIREGRASS DRUGS INC ” Practice Location

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