Healthcare Provider Details

I. General information

NPI: 1750839668
Provider Name (Legal Business Name): FAF INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 11/14/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SAINT CLAIR AVE SE STE 300
HUNTSVILLE AL
35801-4344
US

IV. Provider business mailing address

115 SAINT CLAIR AVE SE STE 300
HUNTSVILLE AL
35801-4344
US

V. Phone/Fax

Practice location:
  • Phone: 256-429-9821
  • Fax: 256-429-9823
Mailing address:
  • Phone: 256-429-9821
  • Fax: 256-429-9823

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 Number114664
License Number StateAL

VIII. Authorized Official

Name: ASHLEY WATSON
Title or Position: PHCY MANGER/AO
Credential:
Phone: 256-705-6499