Provider Demographics
NPI:1912323544
Name:RX EXPRESS PHARMACY OF TILLMAN'S CORNER, INC.
Entity type:Organization
Organization Name:RX EXPRESS PHARMACY OF TILLMAN'S CORNER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:251-661-3851
Mailing Address - Street 1:PO BOX 191390
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-6390
Mailing Address - Country:US
Mailing Address - Phone:251-662-2525
Mailing Address - Fax:251-662-1339
Practice Address - Street 1:5638 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1724
Practice Address - Country:US
Practice Address - Phone:251-662-2525
Practice Address - Fax:251-662-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy