Healthcare Provider Details

I. General information

NPI: 1487052411
Provider Name (Legal Business Name): ICRX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GOVERNORS DR SW
HUNTSVILLE AL
35801-5123
US

IV. Provider business mailing address

301 GOVERNORS DR SW
HUNTSVILLE AL
35801-5123
US

V. Phone/Fax

Practice location:
  • Phone: 256-534-4533
  • Fax: 256-534-1208
Mailing address:
  • Phone: 256-534-4533
  • Fax: 256-534-1208

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 Number114453
License Number StateAL

VIII. Authorized Official

Name: CHRISTINA MACINTOSH
Title or Position: VICE PRESIDENT/PIC/AO
Credential: RPH
Phone: 256-534-4533