Healthcare Provider Details

I. General information

NPI: 1447246251
Provider Name (Legal Business Name): MTM SERVICES OF ALABAMA,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 ST CLAIR AVE
HUNTSVILLE AL
35801-5120
US

IV. Provider business mailing address

409 ST CLAIR AVE
HUNTSVILLE AL
35801-5120
US

V. Phone/Fax

Practice location:
  • Phone: 256-518-9530
  • Fax: 256-518-9531
Mailing address:
  • Phone: 256-518-9530
  • Fax: 256-518-9531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number112821
License Number StateAL

VIII. Authorized Official

Name: MS. REBECCA H. STERLING
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 256-518-9530