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General NPI Number Information
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NPI Number | 1326231119
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Entity Type | Organization
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Legal Business Name | ONCOLOGY SPECIALTIES PC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 3601 CCI DR NW SUITE 12
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City | HUNTSVILLE
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State | AL
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Zip | 35805-2606
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Country | US
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Telephone | 256-705-4224
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18428
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City | HUNTSVILLE
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State | AL
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Zip | 35804-8428
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Country | US
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Telephone | 256-705-4224
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MARIANNE ECHOLS
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Credential |
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Telephone | 256-327-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 112954
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License Number State | AL
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