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General NPI Number Information
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NPI Number | 1760547301
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Entity Type | Organization
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Legal Business Name | FREEMAN PHARMACY, INC.
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 209 W MLK HWY SUITE D
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City | TUSKEGEE
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State | AL
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Zip | 36083
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Country | US
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Telephone | 334-727-0047
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Fax | 334-727-0886
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Provider Business Mailing Address
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Address Line | 209 W. MLK HWY. SUITE D
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City | TUSKEGEE
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State | AL
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Zip | 36083
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Country | US
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Telephone | 334-727-0047
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Fax | 334-727-0886
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. MARK FREEMAN
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Credential |
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Telephone | 334-727-0047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 12782
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12782
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License Number State | AL
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