MEDICARE: MERCYMED OF COLUMBUS 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1689432817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCYMED OF COLUMBUS INC

Provider Business Mailing Address
First Line	:	3600 2ND AVE STE A
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-7470
Country	:	US
Telephone Number	:	706-507-9209
Fax Number	:	706-507-9249

Provider Business Practice Location Address
First Line	:	3600 2ND AVE STE A
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-7470
Country	:	US
Telephone Number	:	706-507-9209
Fax Number	:	706-507-9249

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	DR. NYLVIA WARE
Credential	:	PHARMD, RPH
Telephone Number	:	706-507-9209

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	11/11/2025

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