MEDICARE: PROFESSIONAL APOTHECARY, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51050787	OTHER	AL	BLUE CROSS ALABAMA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407931827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL APOTHECARY, INC.

Provider Business Mailing Address
First Line	:	210 NORTH ST W
Second Line	:
City	:	TALLADEGA
State	:	AL
Zip	:	35160-2083
Country	:	US
Telephone Number	:	256-362-8328
Fax Number	:	256-362-8361

Provider Business Practice Location Address
First Line	:	210 NORTH ST W
Second Line	:
City	:	TALLADEGA
State	:	AL
Zip	:	35160-2083
Country	:	US
Telephone Number	:	256-362-8328
Fax Number	:	256-362-8361

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	BLAKE HARRIS
Credential	:	RPH
Telephone Number	:	256-362-8328

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	02/24/2015

Similar Medicare Providers

1619962511 — PROFESSIONAL APOTHECARY INC.
Practice Location Address:

210 NORTH ST W
TALLADEGA, AL
35160-2083

Practice Phone: 256-362-8328
Practice Fax: 256-362-8361

1982800884 — TALLADEGA NEPHROLOGY, LLC
Practice Location Address:

210 NORTH ST W
TALLADEGA, AL
35160-2083

Practice Phone: 256-521-1996
Practice Fax:

1265662720 — LANDMARK NEPHROLOGY & HYPERTENSION CLINIC. P.C
Practice Location Address:

210 NORTH ST W , SUITE D
TALLADEGA, AL
35160-2083

Practice Phone: 256-283-9760
Practice Fax:

1396043881 — ANTHONY LESSA MD
Practice Location Address:

210 NORTH ST W
TALLADEGA, AL
35160-2083

Practice Phone: 256-362-0066
Practice Fax: 256-362-6700

1871847988 — PREVENTIVE CARE MEDICAL GROUP,LLC
Practice Location Address:

210 NORTH ST W , SUITE C
TALLADEGA, AL
35160-2083

Practice Phone: 256-362-0066
Practice Fax:

1780055319 — PREVENTIVE CARE MEDICL GROUP
Practice Location Address:

210 NORTH ST W , SUITE E
TALLADEGA, AL
35160-2083

Practice Phone: 256-362-0066
Practice Fax: 256-362-6700

Directions to “PROFESSIONAL APOTHECARY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.