Active NPI
Alex Lam
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Moultrie, GA
National Provider Identifier
1083226732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH030593
- Practice address
- 2025 1St Ave SE
Moultrie, GA 31788-5155 - Phone
- (229) 890-2776
- NPI assigned
- Aug 22, 2020
- Last updated
- Aug 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH030593 | GA | Primary |
Addresses
Primary practice location
2025 1St Ave SE
Moultrie, GA 31788-5155
Mailing address
100 Garden Dr Apt B33
Valdosta, GA 31602-5958
Phone (408) 838-3389
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030593 | GA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2025 1st Ave SE
Moultrie, GA 31788
Phone (229) 890-2776
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598054400000",
"number": "1083226732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 GARDEN DR APT B33",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316025958",
"telephone_number": "408-838-3389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 1ST AVE SE",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317885155",
"telephone_number": "229-890-2776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "ALEX",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-22",
"last_updated": "2020-08-22",
"certification_date": "2020-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "GA",
"license": "RPH030593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.