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General NPI Number Information
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NPI Number | 1164575692
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Entity Type | Organization
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Legal Business Name | ACIPCO MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 3200 16TH ST N
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City | BIRMINGHAM
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State | AL
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Zip | 35207-4202
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Country | US
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Telephone | 205-325-7012
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Fax | 205-307-2719
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Provider Business Mailing Address
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Address Line | PO BOX 12725
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City | BIRMINGHAM
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State | AL
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Zip | 35202-6725
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Country | US
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Telephone | 205-325-8081
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Fax | 205-307-2719
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | JOHNNY CURREN
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Credential | RPH
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Telephone | 205-325-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 112743
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License Number State | AL
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