Healthcare Provider Details

I. General information

NPI: 1811001886
Provider Name (Legal Business Name): TPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 DECATUR HWY
FULTONDALE AL
35068-1366
US

IV. Provider business mailing address

3524 DECATUR HWY
FULTONDALE AL
35068-1366
US

V. Phone/Fax

Practice location:
  • Phone: 205-608-4995
  • Fax: 205-608-2718
Mailing address:
  • Phone: 205-608-4995
  • Fax: 205-608-2718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112803
License Number StateAL

VIII. Authorized Official

Name: DR. PAULA HUDSON
Title or Position: PIC/PHARMACY DIRECTOR
Credential: PHARM.D.
Phone: 205-608-4995