Provider Demographics
NPI:1366541203
Name:WIREGRASS DRUGS INC
Entity type:Organization
Organization Name:WIREGRASS DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-435-4571
Mailing Address - Street 1:PO BOX 72188
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-2188
Mailing Address - Country:US
Mailing Address - Phone:229-435-4571
Mailing Address - Fax:
Practice Address - Street 1:5565 HWY 43
Practice Address - Street 2:
Practice Address - City:SATSUMA
Practice Address - State:AL
Practice Address - Zip Code:36572-0488
Practice Address - Country:US
Practice Address - Phone:251-675-2070
Practice Address - Fax:251-675-7785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X, 333600000X
AL1063103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100000143Medicaid
1987936OtherPK
0324320003Medicare NSC