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General NPI Number Information
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NPI Number | 1528323615
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Entity Type | Organization
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Legal Business Name | SHOALS MEDICAL TRIALS, INC.
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 1300 S MONTGOMERY AVE
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City | SHEFFIELD
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State | AL
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Zip | 35660-6334
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Country | US
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Telephone | 256-386-4001
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Fax | 256-386-4179
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Provider Business Mailing Address
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Address Line | 1300 S MONTGOMERY AVE
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City | SHEFFIELD
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State | AL
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Zip | 35660-6334
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Country | US
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Telephone | 256-386-4001
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Fax | 256-386-4179
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Authorized Official
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Title or Position | PRESIDENT
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Name | LYNN MELSON
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Credential |
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Telephone | 256-386-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD.14964
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License Number State | AL
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