Healthcare Provider Details

I. General information

NPI: 1629166830
Provider Name (Legal Business Name): MILLS PHARMACY AT BLUFF PARK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 02/18/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 TYLER RD STE 100
HOOVER AL
35226-1513
US

IV. Provider business mailing address

PO BOX 26679
BIRMINGHAM AL
35260-0679
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-9500
  • Fax: 205-823-0097
Mailing address:
  • Phone: 205-871-9007
  • Fax: 205-874-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112103
License Number StateAL

VIII. Authorized Official

Name: JOSH HARDIN
Title or Position: OWNER
Credential: PHARMD
Phone: 205-427-0955