Healthcare Provider Details

I. General information

NPI: 1316021041
Provider Name (Legal Business Name): ICPM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 7TH ST SO
CLANTON AL
35046-1165
US

IV. Provider business mailing address

914 7TH ST S
CLANTON AL
35045-3718
US

V. Phone/Fax

Practice location:
  • Phone: 205-755-8009
  • Fax: 205-755-5250
Mailing address:
  • Phone: 205-755-8009
  • Fax: 205-755-5250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22795
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DARREN CHRISTOPHER MORTON
Title or Position: OWNER
Credential:
Phone: 205-755-8009