Organization Active NPI

Chancy Drugs Valdosta LLC

  • Community/Retail Pharmacy
  • Valdosta, GA
National Provider Identifier
1669738605
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CHANCY DRUGS VALDOSTA LLC
Practice address
2333 N Ashley St
Valdosta, GA 31602-2621
Phone
(229) 794-3525
Fax
(229) 794-1059
NPI assigned
Apr 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bert A Chancy
Title
Owner
Phone
(229) 794-3525

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X GA Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

2333 N Ashley St
Valdosta, GA 31602-2621

Mailing address

205 E Main St
Hahira, GA 31632-1121
Phone (229) 794-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210107002641 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8426461641 Practice locations: Valdosta, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2108186Chancy Drugs Valdosta2333 N Ashley St, Valdosta, GA 31602Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory

Locations

2333 N Ashley St
Valdosta, GA 31602
Phone (229) 245-9922

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1669738605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E MAIN ST",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316321121",
            "telephone_number": "229-794-3525",
            "fax_number": "229-794-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 N ASHLEY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022621",
            "telephone_number": "229-794-3525",
            "fax_number": "229-794-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCY DRUGS VALDOSTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "CHANCY",
        "authorized_official_first_name": "BERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-794-3525"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.