1154615128 NPI number — BEHAVIORAL HEALTH PHARMACY INNOVATIONS, LLC

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 1154615128 NPI number — BEHAVIORAL HEALTH PHARMACY INNOVATIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL HEALTH PHARMACY INNOVATIONS, LLC
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:
1154615128
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3480 EASTERN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36116-1700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-819-4500
Provider Business Mailing Address Fax Number:
334-819-4520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2033 CORPORATE DR
Provider Second Line Business Practice Location Address:
STE B2
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28405-7464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-859-8211
Provider Business Practice Location Address Fax Number:
910-228-5843
Provider Enumeration Date:
06/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
JANUARY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHRO
Authorized Official Telephone Number:
334-819-4511

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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