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NPI Code Detail

MEDICARE: DURA MED SOUTHEAST INC

MEDICARE: DURA MED SOUTHEAST INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0004XCompounding Pharmacy
43336H0001XHome Infusion Therapy Pharmacy
53336M0002XMail Order Pharmacy
63336C0003XCommunity/Retail Pharmacy111970AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20133645OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144251943
Entity Type Code : Organization
Provider Name (Legal Business Name) : DURA MED SOUTHEAST INC
Provider Business Mailing Address
First Line : 174 HIGHWAY 113
Second Line : PO BOX 1018
City : FLOMATON
State : AL
Zip : 36441-4556
Country : US
Telephone Number : 251-296-4224
Fax Number : 251-296-4226
Provider Business Practice Location Address
First Line : 174 HIGHWAY 113
Second Line :
City : FLOMATON
State : AL
Zip : 36441-4556
Country : US
Telephone Number : 251-296-4224
Fax Number : 251-296-4226
Authorized Official
Title or Position : SUPERVISING PHARMACIST
Name : MISTY BLACKMAN
Credential : RPH
Telephone Number : 251-296-4224
Provider Enumeration Date : 07/06/2006
Last Update Date : 02/22/2010

Similar Medicare Providers

1861490476 — DR. SCOTT GARNER MOORE M.D.
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-296-2456
Practice Fax: 251-296-2400
1124015847 — LISA K HOEHN FNP
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-296-2456
Practice Fax: 251-296-0320
1659531200 — ANNA M. LEE MD
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-296-2456
Practice Fax: 251-296-2400
1700182755 — BILLY JOE GOLDEN JR. NP
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-296-2456
Practice Fax:
1396151924 — BREWTON MEDICAL CENTER PHARMACY PC
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-867-5454
Practice Fax: 251-867-6117
1023596871 — MELISSA GAIL KILCREASE
Practice Location Address:
174 HIGHWAY 113
FLOMATON, AL
36441-4556
Practice Phone: 251-296-2456
Practice Fax: 251-296-2400

Directions to “DURA MED SOUTHEAST INC ” Practice Location

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