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General NPI Number Information
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NPI Number | 1891771515
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Entity Type | Organization
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Legal Business Name | MED-SOUTH, INC.
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 206A OAK MOUNTAIN CIR
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City | PELHAM
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State | AL
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Zip | 35124-1357
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Country | US
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Telephone | 205-982-5058
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Fax | 205-982-6998
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Provider Business Mailing Address
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Address Line | 406 MEDICAL CENTER DR
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City | JASPER
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State | AL
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Zip | 35501-3400
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Country | US
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Telephone | 205-221-8200
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Fax | 205-221-8270
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Authorized Official
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Title or Position | SR VICE PRESIDENT OF CORPORATE DEVE
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Name | MR. STEWART H PACE
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Credential |
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Telephone | 205-414-7525
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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 | 111939
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License Number State | AL
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