Healthcare Provider Details

I. General information

NPI: 1912205758
Provider Name (Legal Business Name): BAITSHOP INVESTMENTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5129 HIGHWAY 17
HELENA AL
35080-3514
US

IV. Provider business mailing address

5129 HIGHWAY 17
HELENA AL
35080-3514
US

V. Phone/Fax

Practice location:
  • Phone: 205-745-3979
  • Fax:
Mailing address:
  • Phone: 205-745-3979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number113525
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. WILMER SCOTT ARLEDGE
Title or Position: PRESIDENT/OWNER
Credential: R.PH.
Phone: 205-745-3979