Healthcare Provider Details

I. General information

NPI: 1699816892
Provider Name (Legal Business Name): PRESCRIPTION SPECIALTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3349 INDEPENDENCE DR SUITE 102
BIRMINGHAM AL
35209-8310
US

IV. Provider business mailing address

3349 INDEPENDENCE DR SUITE 102
BIRMINGHAM AL
35209-8310
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-3150
  • Fax: 855-862-0446
Mailing address:
  • Phone: 205-870-3150
  • Fax: 855-862-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number110693
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. REGINALD BRANDON FREEMAN
Title or Position: PHARM.D.
Credential:
Phone: 205-870-3150