Healthcare Provider Details

I. General information

NPI: 1023375185
Provider Name (Legal Business Name): PHARMACY LINK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3648 VANN RD BUILDING II SUITE 116
BIRMINGHAM AL
35235-3273
US

IV. Provider business mailing address

PO BOX 94
ALTON AL
35015-0094
US

V. Phone/Fax

Practice location:
  • Phone: 205-836-1414
  • Fax: 866-374-4761
Mailing address:
  • Phone: 205-661-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number113886
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY RICCIARDONE
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 866-332-6966