Healthcare Provider Details

I. General information

NPI: 1124060793
Provider Name (Legal Business Name): CONCEPT PHARMACEUTICALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 ANN ST
MONTGOMERY AL
36107-3103
US

IV. Provider business mailing address

1460 ANN ST
MONTGOMERY AL
36107-3103
US

V. Phone/Fax

Practice location:
  • Phone: 334-386-1261
  • Fax: 800-856-7820
Mailing address:
  • Phone: 800-784-0149
  • Fax: 800-856-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number112714
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREG MCNIDER
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARM.D.
Phone: 800-784-0149