Healthcare Provider Details

I. General information

NPI: 1659707891
Provider Name (Legal Business Name): NEW MARKET HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 WINCHESTER RD
NEW MARKET AL
35761-7430
US

IV. Provider business mailing address

PO BOX 709
ATHENS AL
35612-0709
US

V. Phone/Fax

Practice location:
  • Phone: 256-379-4670
  • Fax: 256-379-4680
Mailing address:
  • Phone: 256-232-3811
  • Fax: 256-232-2422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112550
License Number StateAL

VIII. Authorized Official

Name: CHANDLER WILLINGHAM
Title or Position: CO OWNER
Credential:
Phone: 256-232-3811