Healthcare Provider Details

I. General information

NPI: 1932197415
Provider Name (Legal Business Name): PHARMACY CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 COTTON GIN ROAD
MONTGOMERY AL
36117-3552
US

IV. Provider business mailing address

545 COTTON GIN ROAD
MONTGOMERY AL
36117-3552
US

V. Phone/Fax

Practice location:
  • Phone: 334-396-9466
  • Fax: 334-386-8496
Mailing address:
  • Phone: 334-396-9466
  • Fax: 334-386-8496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number111630
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number111
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN DANE YARBROUGH
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 334-396-9466