Healthcare Provider Details

I. General information

NPI: 1235544487
Provider Name (Legal Business Name): ANTHONY J BOLUS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 TYLER RD STE 104
HOOVER AL
35226-1305
US

IV. Provider business mailing address

2148 TYLER RD STE 104
HOOVER AL
35226-1305
US

V. Phone/Fax

Practice location:
  • Phone: 205-453-7544
  • Fax: 205-823-0097
Mailing address:
  • Phone: 205-453-7544
  • Fax: 205-823-0097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17499
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number17499
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: