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General NPI Number Information
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NPI Number | 1750914545
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Entity Type | Organization
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Legal Business Name | ALABAMA LTC PHARMACY LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 611 MCFARLAND BLVD STE D
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City | NORTHPORT
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State | AL
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Zip | 35476-3333
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Country | US
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Telephone | 205-632-5455
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Fax | 205-333-6201
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Provider Business Mailing Address
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Address Line | 611 MCFARLAND BLVD STE D
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City | NORTHPORT
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State | AL
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Zip | 35476-3333
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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
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Name | LOGAN DAVIS
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Credential |
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Telephone | 205-632-5455
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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