Healthcare Provider Details

I. General information

NPI: 1386005247
Provider Name (Legal Business Name): MEDICAL CENTER PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N COLUMBIA AVE
SHEFFIELD AL
35660-2935
US

IV. Provider business mailing address

507 N COLUMBIA AVE
SHEFFIELD AL
35660-2935
US

V. Phone/Fax

Practice location:
  • Phone: 256-381-4311
  • Fax: 256-386-0903
Mailing address:
  • Phone: 256-381-4311
  • Fax: 256-386-0903

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 Number106701
License Number StateAL

VIII. Authorized Official

Name: MICHAEL SIGMON
Title or Position: OWNER
Credential:
Phone: 423-312-3191