Healthcare Provider Details

I. General information

NPI: 1982235230
Provider Name (Legal Business Name): SHIFTRX UAB MW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 01/23/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 9TH AVE SW STE 100
BESSEMER AL
35022-7810
US

IV. Provider business mailing address

985 9TH AVE SW STE 100
BESSEMER AL
35022-7810
US

V. Phone/Fax

Practice location:
  • Phone: 205-426-3784
  • Fax: 205-426-3763
Mailing address:
  • Phone: 205-426-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JEROMIE RAY LOVINGOOD
Title or Position: DIRECTOR
Credential:
Phone: 205-426-3784