Healthcare Provider Details

I. General information

NPI: 1407921943
Provider Name (Legal Business Name): CORPORATE HEALTH DIMENSIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 GOODYEAR AVE
GADSDEN AL
35903-1133
US

IV. Provider business mailing address

40 BURTON HILLS BLVD SUITE 200
NASHVILLE TN
37215-6155
US

V. Phone/Fax

Practice location:
  • Phone: 125-649-2659
  • Fax: 125-649-4506
Mailing address:
  • Phone: 161-566-5950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number102790
License Number StateAL

VIII. Authorized Official

Name: MR. KEVIN BICE
Title or Position: CORPORATE DIRECTOR OF PHARMACY
Credential: RPH
Phone: 16156659500