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General NPI Number Information
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NPI Number | 1912862202
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Entity Type | Organization
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Legal Business Name | PIKE ROAD PHARMACY
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 9558 VAUGHN ROAD
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City | PIKE ROAD
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State | AL
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Zip | 36064
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Country | US
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Telephone | 334-398-7765
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Fax | 334-398-7841
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Provider Business Mailing Address
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Address Line | 9558 VAUGHN ROAD
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City | PIKE ROAD
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State | AL
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Zip | 36064
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Country | US
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Telephone | 334-398-7765
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Fax | 334-398-7841
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | JEREMY MICHAEL NOLAN
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Credential |
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Telephone | 334-202-1104
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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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