Provider Demographics
NPI:1396755997
Name:BREWER MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:BREWER MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-389-9393
Mailing Address - Street 1:2724 N JACKSON HWY
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-3431
Mailing Address - Country:US
Mailing Address - Phone:256-389-9393
Mailing Address - Fax:256-383-1870
Practice Address - Street 1:2724 N JACKSON HWY
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-3431
Practice Address - Country:US
Practice Address - Phone:256-389-9393
Practice Address - Fax:256-383-1870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0111459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0111459Medicaid
AL0111459OtherPHARMACY
AL0111459Medicare ID - Type UnspecifiedPHARMACY