Healthcare Provider Details

I. General information

NPI: 1073938775
Provider Name (Legal Business Name): CAREMAX PHARMACY OF LOUDON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5331 PERIMETER PKWY
MONTGOMERY AL
36116-5125
US

IV. Provider business mailing address

3033 W PRESIDENT GEORGE BUSH HWY STE 100
PLANO TX
75075-5752
US

V. Phone/Fax

Practice location:
  • Phone: 334-220-2282
  • Fax: 865-525-0522
Mailing address:
  • Phone: 972-588-1000
  • Fax: 972-588-1001

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number114303
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMY MULDERRY
Title or Position: PRESIDENT
Credential:
Phone: 972-588-1000