Healthcare Provider Details

I. General information

NPI: 1801836556
Provider Name (Legal Business Name): JEFFERSON HEALTH SYSTEM PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1948
US

IV. Provider business mailing address

1308 TUSCALOOSA AVE SW
BIRMINGHAM AL
35211-1948
US

V. Phone/Fax

Practice location:
  • Phone: 205-715-6129
  • Fax: 205-715-6201
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number180076
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GLEN THOMPSON
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 205-930-3359