Active NPI
Chancy Drugs Valdosta LLC
- Community/Retail Pharmacy
- Valdosta, GA
National Provider Identifier
1669738605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210107002641 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8426461641 | Practice locations: Valdosta, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2108186 | Chancy Drugs Valdosta | Certificate of waiver | Jan 28, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacist
- Valdosta, GA
- NPI 1356938344
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.