Healthcare Provider Details

I. General information

NPI: 1265582688
Provider Name (Legal Business Name): CARROLL TOTAL CARE PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 OLD SPRINGVILLE RD
PINSON AL
35126-3039
US

IV. Provider business mailing address

6767 OLD SPRINGVILLE RD
PINSON AL
35126-3039
US

V. Phone/Fax

Practice location:
  • Phone: 205-680-5557
  • Fax: 205-680-5502
Mailing address:
  • Phone: 205-680-5557
  • Fax: 205-680-5502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number110500
License Number StateAL

VIII. Authorized Official

Name: MR. GREG W CARROLL
Title or Position: C.E.O
Credential: R.PH.
Phone: 205-680-5557