Healthcare Provider Details

I. General information

NPI: 1629125778
Provider Name (Legal Business Name): HARBIN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/19/2025
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 CHURCH ST STE A
MOUNTAIN BRK AL
35213-3701
US

IV. Provider business mailing address

57 CHURCH ST
MOUNTAIN BRK AL
35213-3701
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-1296
  • Fax: 205-871-6845
Mailing address:
  • Phone: 205-871-1296
  • Fax: 205-871-6845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number105040
License Number StateAL

VIII. Authorized Official

Name: JERRY NEWMAN
Title or Position: OWNER/AO
Credential: RPH
Phone: 205-871-4438