Basic Information
| Provider Information | |||||||||
| NPI: | 1386028256 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSAE | ||||||||
| FirstName: | SHARMON | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317012053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293122153 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2336 DAWSON RD | ||||||||
| Address2: | #1500 | ||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317072800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293128800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2015 | ||||||||
| LastUpdateDate: | 08/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PCT.0012955 | CT | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.