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General NPI Number Information
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NPI Number | 1710698717
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Entity Type | Organization
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Legal Business Name | MOBILE INFIRMARY ASSOCIATION
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 7101 US HIGHWAY 90 BUILDING B, SUITE B100
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City | DAPHNE
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State | AL
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Zip | 36526-9512
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Country | US
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Telephone | 251-625-8445
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1468
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City | DAPHNE
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State | AL
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Zip | 36526-1468
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DOUGLAS MARK NIX
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Credential |
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Telephone | 251-625-8454
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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