Healthcare Provider Details

I. General information

NPI: 1679513428
Provider Name (Legal Business Name): JEFFERSON COUNTY COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 6TH AVE S
BIRMINGHAM AL
35233-1601
US

IV. Provider business mailing address

COOPER GREEN MERCY HEALTH SERVICES 1515 6TH AVE S
BIRMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-3244
  • Fax: 205-930-3648
Mailing address:
  • Phone: 205-930-3244
  • Fax: 205-930-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number113162
License Number StateAL

VIII. Authorized Official

Name: ANNA HILL
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 205-918-2353