Organization Active NPI

Gilchrist Pharmacy, Inc.

  • Pharmacy
  • Hartselle, AL
National Provider Identifier
1841297314
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
523587 Issued in AL
Legal business name
GILCHRIST PHARMACY, INC.
Practice address
404 Sparkman St NW
Hartselle, AL 35640-2326
Phone
(256) 773-1998
Fax
(256) 751-0625
NPI assigned
Jun 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
Michael Wayne PreuittNPI 1881603603
Title
Owner
Phone
(256) 773-1998

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 523587 AL Primary

Addresses

Primary practice location

404 Sparkman St NW
Hartselle, AL 35640-2326

Mailing address

404 Sparkman St NW
Hartselle, AL 35640-2326
Phone (256) 773-1998

Other identifiers 1

IdentifierTypeStateIssuer
100001656MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180712000924 AL Part B Supplier - Mass Immunization (Roster Biller Only) 5496001075 1 other NPI on this enrollment
Practice locations: Hartselle, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
01D2097851Gilchrist Pharmacy Inc404 Sparkman St NW, Hartselle, AL 35640Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gilchrist Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

404 Sparkman St NW
Hartselle, AL 35640
Phone (256) 560-2231

Practitioners & affiliated clinicians

Practitioners 3

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": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1841297314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 SPARKMAN ST NW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402326",
            "telephone_number": "256-773-1998",
            "fax_number": "256-751-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 SPARKMAN ST NW",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356402326",
            "telephone_number": "256-773-1998",
            "fax_number": "256-751-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILCHRIST PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "PREUITT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-773-1998"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "523587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001656",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartselle, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.