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General NPI Number Information
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NPI Number | 1790025609
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Entity Type | Organization
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Legal Business Name | MEDTOWN, LLC
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Dates
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Enumeration Date | 03/01/2013
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 24333 AL HIGHWAY 24 SUITE A
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City | TRINITY
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State | AL
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Zip | 35673-5380
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Country | US
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Telephone | 256-353-8997
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Fax | 256-353-8661
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Provider Business Mailing Address
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Address Line | 24333 AL HIGHWAY 24 SUITE A
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City | TRINITY
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State | AL
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Zip | 35673-5380
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Country | US
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Telephone | 256-353-8997
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Fax | 256-353-8661
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER SIMPSON
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Credential |
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Telephone | 205-420-1691
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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 | 114042
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License Number State | AL
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