Healthcare Provider Details

I. General information

NPI: 1205572732
Provider Name (Legal Business Name): BIRMINGHAM APOTHECARY LONG TERM CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2022
Last Update Date: 07/26/2023
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 20TH ST S
BIRMINGHAM AL
35205-2606
US

IV. Provider business mailing address

1032 20TH ST S
BIRMINGHAM AL
35205-2606
US

V. Phone/Fax

Practice location:
  • Phone: 205-251-4248
  • Fax:
Mailing address:
  • Phone: 205-251-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AJ PATEL
Title or Position: OWNER
Credential:
Phone: 205-251-4248