MEDICARE: MANVEL EXPRESS PHARMACY LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1467055061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANVEL EXPRESS PHARMACY LLC

Provider Business Mailing Address
First Line	:	3480 EASTERN BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-1700
Country	:	US
Telephone Number	:	334-819-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 FANNIN ST STE 1750
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2959
Country	:	US
Telephone Number	:	326-685-3588
Fax Number	:

Authorized Official
Title or Position	:	VP, HR
Name	:	JANUARY MILLER
Credential	:
Telephone Number	:	334-819-4511

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	02/19/2026

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