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SOPERTON PHARMACY INC NPI 1558339838


NPI Information

NPI: 1558339838
Provider Name: SOPERTON PHARMACY, INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 11D1022317

Address:
112 MAIN ST W
SOPERTON, GA
ZIP 30457
Phone: (912) 529-3234
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SOPERTON PHARMACY, INC is a durable medical equipment medical supplies in Soperton, GA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. SOPERTON PHARMACY, INC NPI is 1558339838. The provider is registered as an organization entity type.

The provider's business location address is:

112 MAIN ST W
SOPERTON, GA
ZIP 30457-169
Phone: (912) 529-3234
Fax: (912) 529-6197

The provider's authorized official is E Wesley Crowe .
The authorized official title is President and has the following contact phone number (912) 529-3234.

The CLIA number assigned to this NPI record is 11D1022317 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/10/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesPHERE003318GEORGIAYes
23336C0003XPharmacyCommunity/Retail PharmacyPHRE003318GEORGIAX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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