Chancy Drugs Hahira LLC
Organization Active NPI Community/Retail Pharmacy · Hahira, GA
NPI 1144308552 · NPPES record last updated Jun 10, 2015
Key facts
- NPI
- 1144308552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE003128 (GA)
- Legal business name
- CHANCY DRUGS HAHIRA LLC
- Practice address
- 205 E Main St
Hahira, GA 31632-1121 - Phone
- (229) 794-2750
- Fax
- (229) 794-4092
- NPI assigned
- Nov 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Beth Rountree
- Title
- Pharmacist in Charge
- Phone
- (229) 794-2750
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110308000187 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8921280280 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hahira, GA |
National Provider Directory
- Tax ID family
- Chancy Drugs
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHRE003128 | GA | Yes |
| Long Term Care Pharmacy | 3336L0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
205 E Main St
Hahira, GA 31632-1121
Mailing address
205 E Main St
Hahira, GA 31632-1121
Phone (229) 794-2750
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00023053A | Medicaid | GA | |
| 2012397 | Other | PK |
Other names
- CHANCY DRUGS
Other providers in Hahira, GA
- Elizabeth Beckham Bickers
- Carter Pediatric Therapy Services,LLC
- Melody Renee Carter RN
- Nicholas R Castillo
- Chancy Drugs
- Chancy Drugs Inc
- Chancy Drugs LTC LLC
- Chancy Drugs LTC LLC
- Chancy Drugs, Inc
- Hugh Michael Chancy
All providers in Hahira, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.