Healthcare Provider Details
I. General information
NPI: 1467486233
Provider Name (Legal Business Name): CONNER & MCCONAGHY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5567 HIGHWAY 43
SATSUMA AL
36572-2108
US
IV. Provider business mailing address
PO BOX 558
SATSUMA AL
36572-0558
US
V. Phone/Fax
- Phone: 251-675-3228
- Fax: 251-675-4209
- Phone: 251-675-3228
- Fax: 251-675-4209
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 102030 |
| License Number State | AL |
VIII. Authorized Official
Name:
DAN
MCCONAGHY
Title or Position: OWNER
Credential:
Phone: 251-675-3228