Healthcare Provider Details

I. General information

NPI: 1114981347
Provider Name (Legal Business Name): BESSEMER APOTHECARY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 19TH ST N
BESSEMER AL
35020-4931
US

IV. Provider business mailing address

230 19TH ST N
BESSEMER AL
35020-4931
US

V. Phone/Fax

Practice location:
  • Phone: 205-425-1641
  • Fax: 205-425-1642
Mailing address:
  • Phone: 205-425-1641
  • Fax: 205-425-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number112215
License Number StateAL

VIII. Authorized Official

Name: MR. ALLEN BROOKS
Title or Position: OWNER
Credential: DRUGGIST
Phone: 205-425-1641