1922352566 NPI number — HMR OF ALABAMA INC

Table of content: (NPI 1922352566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922352566 NPI number — HMR OF ALABAMA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HMR OF ALABAMA 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:
GSI PHARMACY OF HUNTSVILLE
Provider Other Organization Name Type Code:
3
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:
1922352566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 JUSTICE LN
Provider Second Line Business Mailing Address:
PO BOX 5285
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29621-2354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-224-3898
Provider Business Mailing Address Fax Number:
864-224-3609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2701 MERIDIAN ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35811-1845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-582-5170
Provider Business Practice Location Address Fax Number:
256-859-4115
Provider Enumeration Date:
11/05/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TWITTY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED SIGNATORY
Authorized Official Telephone Number:
864-224-3898

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X , with the licence number:  180181 , 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: 2146922 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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