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General NPI Number Information
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NPI Number | 1760557227
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Entity Type | Organization
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Legal Business Name | INDEPENDENT HEALTH SERVICES
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 504 MCCURDY AVE SW STE 100
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City | RAINSVILLE
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State | AL
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Zip | 35986
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Country | US
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Telephone | 256-638-1060
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Fax | 256-638-1061
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Provider Business Mailing Address
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Address Line | PO BOX 1428
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City | RAINSVILLE
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State | AL
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Zip | 35986
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Country | US
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Telephone | 256-638-1060
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Fax | 256-638-1061
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Authorized Official
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Title or Position | VP AND GENERAL COUNSEL
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Name | MS. MYRA L SANDERSON
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Credential | JD
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Telephone | 256-638-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 111570
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License Number State | AL
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