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General NPI Number Information
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NPI Number | 1013312503
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Entity Type | Organization
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Legal Business Name | TOTAL RECALL RX LLC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3008 CLAIRMONT AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1113
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Country | US
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Telephone | 205-243-9919
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Fax | 205-297-0012
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Provider Business Mailing Address
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Address Line | 3008 CLAIRMONT AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1113
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Country | US
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Telephone | 205-243-9919
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Fax | 205-297-0012
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL B HERRON
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Credential |
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Telephone | 205-243-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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