Healthcare Provider Details

I. General information

NPI: 1417093485
Provider Name (Legal Business Name): THE PHARMACY AT HAMPTON PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6727 HIGHWAY 431 S SUITE M
HAMPTON COVE AL
35763-9225
US

IV. Provider business mailing address

6727 HIGHWAY 431 S SUITE M
HAMPTON COVE AL
35763-9225
US

V. Phone/Fax

Practice location:
  • Phone: 256-425-0054
  • Fax: 256-425-0057
Mailing address:
  • Phone: 256-425-0054
  • Fax: 256-425-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112311
License Number StateAL

VIII. Authorized Official

Name: DAN L HORN
Title or Position: SUPERVISING PHARMACIST
Credential: RPH
Phone: 256-425-0054