Healthcare Provider Details

I. General information

NPI: 1740268499
Provider Name (Legal Business Name): STAR DISCOUNT PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12078 HIGHWAY 231 431 N
MERIDIANVILLE AL
35759-1225
US

IV. Provider business mailing address

12078 HIGHWAY 231 431 N
MERIDIANVILLE AL
35759-1225
US

V. Phone/Fax

Practice location:
  • Phone: 256-829-0209
  • Fax: 256-829-0992
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112104
License Number StateAL

VIII. Authorized Official

Name: DARDEN HERITAGE
Title or Position: PRESIDENT
Credential:
Phone: 256-534-1118