Healthcare Provider Details

I. General information

NPI: 1700938974
Provider Name (Legal Business Name): AUBURN UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 WALKER BUILDING
AUBURN AL
36849-5501
US

IV. Provider business mailing address

2150 WALKER BUILDING
AUBURN AL
36849-5501
US

V. Phone/Fax

Practice location:
  • Phone: 334-844-8938
  • Fax: 334-844-8983
Mailing address:
  • Phone: 334-844-8938
  • Fax: 334-844-8983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112744
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREG PEDEN
Title or Position: COORDINATOR OF PHARMACY SVCS
Credential:
Phone: 334-844-4643