Provider Demographics
NPI:1194891937
Name:MEDICAL ARTS PHARMACY OF HUNTSVILLE, INC.
Entity type:Organization
Organization Name:MEDICAL ARTS PHARMACY OF HUNTSVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-534-6438
Mailing Address - Street 1:2012 WHITESBURG DR S
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4542
Mailing Address - Country:US
Mailing Address - Phone:256-534-6438
Mailing Address - Fax:256-533-5640
Practice Address - Street 1:2012 WHITESBURG DR S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4542
Practice Address - Country:US
Practice Address - Phone:256-534-6438
Practice Address - Fax:256-533-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1066003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1179710001Medicare ID - Type Unspecified