Healthcare Provider Details

I. General information

NPI: 1609866615
Provider Name (Legal Business Name): MORTAR&PESTLE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 FIELDSTOWN RD
GARDENDALE AL
35071-2454
US

IV. Provider business mailing address

200 FIELDSTOWN RD P.O. BOX 1592
GARDENDALE AL
35071-2454
US

V. Phone/Fax

Practice location:
  • Phone: 205-631-0058
  • Fax: 205-631-0787
Mailing address:
  • Phone: 205-631-0058
  • Fax: 205-631-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number110470
License Number StateAL

VIII. Authorized Official

Name: MRS. RUTHANN M. SCHAEFERS
Title or Position: VICE PRESIDENT OWNER
Credential: RPH
Phone: 205-631-0058