MEDICARE: MTM SERVICES OF ALABAMA,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	333600000X	Pharmacy	112821	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447246251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MTM SERVICES OF ALABAMA,INC.

Provider Business Mailing Address
First Line	:	409 ST CLAIR AVE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5120
Country	:	US
Telephone Number	:	256-518-9530
Fax Number	:	256-518-9531

Provider Business Practice Location Address
First Line	:	409 ST CLAIR AVE
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5120
Country	:	US
Telephone Number	:	256-518-9530
Fax Number	:	256-518-9531

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MS. REBECCA H. STERLING
Credential	:
Telephone Number	:	256-518-9530

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	11/15/2012

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