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PROCARE PHARMACY, LLC

Specialty Pharmacy

A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

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Contact Information

PROCARE PHARMACY, LLC
2700 NORTHEAST EXPY NE
SUITE B-800
ATLANTA, GA  30345
 Phone: 404-367-9111
 Fax: 404-367-9199
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Specialty Pharmacy

 3336S0011X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

 3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

 332B00000X 54 Other Medical Supply Company
 

Pharmacy

 333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PROCARE PHARMACY, LLC

NPI Number 1417216128
LBN Legal business name PROCARE PHARMACY, LLC
Authorized official BRANDON AYCOCK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/15/2012
Last updated 12/10/2025 - About 6 months ago
Identifiers
GA License # PHRE009830
DC Medicaid 058513900
GA Medicaid 003123975A
SC Medicaid 7G9830
VA Medicaid 1417216128
Other 2135141 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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