Albany Addiction Associates, INC. D/B/A Private Clinic Albany
Pharmacist, Pharmacotherapy in Albany, GA. Organization (NPI-2).
NPI number1124331970
StatusActive
Last updated in NPPESJul 22, 2010
Details
- NPI
- 1124331970
- Entity type
- Organization (NPI-2)
- Legal business name
- Albany Addiction Associates, INC. D/B/A Private Clinic Albany
- Organization subpart
- No
- Enumeration date
- Jul 22, 2010
- Last updated
- Jul 22, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P1200X | Pharmacist, Pharmacotherapy | PHOP000026 | GA | Yes |
| 2084A0401X | Psychiatry & Neurology, Addiction Medicine | NTP001025 | GA |
Practice location
2607 Ledo RdAlbany, GA 31707-1211
Phone 229-903-0022 · Fax 229-903-0025
Mailing address
2607 Ledo RdAlbany, GA 31707-1211
Phone 229-903-0022 · Fax 229-903-0025
Authorized official
Jonathan Paul Connell
President
2299030022
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