Healthcare Provider Details

I. General information

NPI: 1841341724
Provider Name (Legal Business Name): AUBURN UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LEM MORRISON DR
AUBURN AL
36849-0001
US

IV. Provider business mailing address

400 LEM MORRISON DR
AUBURN AL
36849-0001
US

V. Phone/Fax

Practice location:
  • Phone: 334-844-4641
  • Fax: 334-844-4969
Mailing address:
  • Phone: 334-844-4641
  • Fax: 334-844-4969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number110704
License Number StateAL

VIII. Authorized Official

Name: GREG PEDEN
Title or Position: COOR OF PHARMACY SERVICES
Credential:
Phone: 334-844-4643