1043227044 NPI number — LINCOLN PHARMACY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043227044 NPI number — LINCOLN PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINCOLN PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043227044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 JD SMITH DR
Provider Second Line Business Mailing Address:
ALACO WAREHOUSE BUSINESS OFFICE
Provider Business Mailing Address City Name:
ATTALLA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35954-3350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-538-5697
Provider Business Mailing Address Fax Number:
256-538-0239

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99 MAGNOLIA ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35096-0200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-763-7759
Provider Business Practice Location Address Fax Number:
205-763-2131
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STRICKLAND
Authorized Official First Name:
RON
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
205-763-7759

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  111394 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0128529 . This is a "NABP" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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