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NPI Code Detail

MEDICARE: BREWTON MEDICAL CENTER PHARMACY PC

MEDICARE: BREWTON MEDICAL CENTER PHARMACY PC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy114383AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22146701OTHERPK

General Provider Information

NPI Number : 1396151924
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREWTON MEDICAL CENTER PHARMACY PC
Provider Business Mailing Address
First Line : 174 HIGHWAY 113
Second Line :
City : FLOMATON
State : AL
Zip : 36441-4556
Country : US
Telephone Number : 251-867-5454
Fax Number : 251-867-6117
Provider Business Practice Location Address
First Line : 174 HIGHWAY 113
Second Line :
City : FLOMATON
State : AL
Zip : 36441-4556
Country : US
Telephone Number : 251-867-5454
Fax Number : 251-867-6117
Authorized Official
Title or Position : PRESIDENT
Name : CHARLES COTTRELL
Credential :
Telephone Number : 251-802-0387
Provider Enumeration Date : 07/02/2014
Last Update Date : 10/21/2024

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Directions to “BREWTON MEDICAL CENTER PHARMACY PC ” Practice Location

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