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NPI Code Detail

MEDICARE: JEFFERSON HEALTH SYSTEM PHARMACY

MEDICARE: JEFFERSON HEALTH SYSTEM PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy160022AL
23336C0002XClinic Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10117778OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1245271071
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFERSON HEALTH SYSTEM PHARMACY
Provider Business Mailing Address
First Line : 1700 AVENUE E ENSLEY
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35218-1543
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 AVENUE E ENSLEY
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35218-1543
Country : US
Telephone Number : 205-241-5240
Fax Number : 205-241-5299
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : GLEN THOMPSON
Credential :
Telephone Number : 205-930-3359
Provider Enumeration Date : 06/10/2006
Last Update Date : 09/11/2025

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Directions to “JEFFERSON HEALTH SYSTEM PHARMACY ” Practice Location

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