Healthcare Provider Details

I. General information

NPI: 1801829403
Provider Name (Legal Business Name): HONESTY MEDICATION THERAPY MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DOWNTOWNER BLVD STE 106
MOBILE AL
36609-5416
US

IV. Provider business mailing address

800 DOWNTOWNER BLVD STE 106
MOBILE AL
36609-5416
US

V. Phone/Fax

Practice location:
  • Phone: 251-414-3050
  • Fax:
Mailing address:
  • Phone: 251-414-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number15106
License Number StateAL

VIII. Authorized Official

Name: DR. JERMAINE GERARD TILLER
Title or Position: CONSULTANT PHARMACIST
Credential: PHARM D
Phone: 251-414-3050