Healthcare Provider Details

I. General information

NPI: 1063335396
Provider Name (Legal Business Name): EAST ALABAMA MENTAL HEALTH-MENTAL RETARDATION BOARD INCORPOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 LAMBERT DR
OPELIKA AL
36801-7237
US

IV. Provider business mailing address

2506 LAMBERT DR
OPELIKA AL
36801-7237
US

V. Phone/Fax

Practice location:
  • Phone: 334-742-2700
  • Fax: 334-742-2840
Mailing address:
  • Phone: 334-742-2700
  • Fax: 334-742-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JIMMIE DICKEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 334-742-2700