Healthcare Provider Details

I. General information

NPI: 1003452467
Provider Name (Legal Business Name): FIDELIS SERVUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 HELENA MARKET PL
HELENA AL
35080-3563
US

IV. Provider business mailing address

16688 HIGHWAY 280
CHELSEA AL
35043-8367
US

V. Phone/Fax

Practice location:
  • Phone: 205-729-5060
  • Fax: 205-729-5061
Mailing address:
  • Phone: 205-678-7755
  • Fax: 205-678-0900

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 Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM HONEA II
Title or Position: PRESIDENT
Credential: PHARM.D
Phone: 205-678-7755