Healthcare Provider Details

I. General information

NPI: 1295662799
Provider Name (Legal Business Name): MILLENNIARX GULF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5462 ABLE CT
MOBILE AL
36693-3100
US

IV. Provider business mailing address

5462 ABLE CT
MOBILE AL
36693-3100
US

V. Phone/Fax

Practice location:
  • Phone: 205-618-5767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BINYAMIN GREENBERG
Title or Position: PRESIDENT
Credential:
Phone: 205-618-5767