Healthcare Provider Details

I. General information

NPI: 1780617191
Provider Name (Legal Business Name): SORCON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 CAHABA RD
MOUNTAIN BROOK AL
35223-2304
US

IV. Provider business mailing address

2714 CAHABA RD
MOUNTAIN BROOK AL
35223-2304
US

V. Phone/Fax

Practice location:
  • Phone: 205-871-1141
  • Fax: 205-871-7439
Mailing address:
  • Phone: 205-871-1141
  • Fax: 205-871-7439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number110792
License Number StateAL

VIII. Authorized Official

Name: MR. RALPH EVANS SORRELL JR.
Title or Position: PHARMACIST/PRESIDENT
Credential: RPH
Phone: 205-871-1141