Healthcare Provider Details

I. General information

NPI: 1942688676
Provider Name (Legal Business Name): VULCAN RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2496 ROCKY RIDGE RD
VESTAVIA AL
35243-2850
US

IV. Provider business mailing address

2496 ROCKY RIDGE RD
VESTAVIA AL
35243-2850
US

V. Phone/Fax

Practice location:
  • Phone: 205-438-6377
  • Fax: 888-892-3452
Mailing address:
  • Phone: 205-438-6377
  • Fax: 888-892-3452

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 Number114469
License Number StateAL

VIII. Authorized Official

Name: EDDIE BARNETT
Title or Position: OWNER
Credential:
Phone: 205-438-6377