Healthcare Provider Details

I. General information

NPI: 1982920724
Provider Name (Legal Business Name): JAMES LOYD MCMILLIN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 CLOVERDALE RD
FLORENCE AL
35633-1339
US

IV. Provider business mailing address

1733 LINGERLOST RD
KILLEN AL
35645-8737
US

V. Phone/Fax

Practice location:
  • Phone: 256-766-1224
  • Fax:
Mailing address:
  • Phone: 256-757-1487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9040
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: