MEDICARE: SOUTH ALBANY PHARMACY

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
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841320801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH ALBANY PHARMACY

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	:	229-878-4926

Provider Business Practice Location Address
First Line	:	1508 E EVANS ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39819-4364
Country	:	US
Telephone Number	:	229-246-7733
Fax Number	:	229-246-7968

Authorized Official
Title or Position	:	OWNER
Name	:	LORI BETH MCLEAN
Credential	:
Telephone Number	:	229-435-5199

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	11/18/2025

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Directions to “SOUTH ALBANY PHARMACY ” Practice Location

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