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General NPI Number Information
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NPI Number | 1437748498
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Entity Type | Organization
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Legal Business Name | WELTRAK MTM LLC
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 5354 SALMON CT
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City | MOBILE
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State | AL
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Zip | 36693-2556
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Country | US
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Telephone | 251-680-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 5354 SALMON CT
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City | MOBILE
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State | AL
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Zip | 36693-2556
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Country | US
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Telephone | 251-680-0109
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JAMES M PUCKETT III
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Credential | PHARMD, BCGP
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Telephone | 251-680-0109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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