# TRUSSVILLE TOTAL CARE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carroll Pharmacy Trussville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154642304
- **Authorized official:** GREG CARROLL R.PH (OWNER)
- **Authorized official phone:** (205) 680-5557

## Contact information

- **Practice address:** 115 N CHALKVILLE RD, TRUSSVILLE, AL 35173-1376
- **Practice address phone:** (205) 655-3455
- **Practice address fax:** (205) 655-3425
- **Mailing address:** PO BOX 252, CLAY, AL 35048-0252
- **Mailing address phone:** (205) 655-3455
- **Mailing address fax:** (205) 655-3425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WD0400X | Diabetes Educator Registered Nurse | — | NULL | — |
| 163WD0400X | Diabetes Educator Registered Nurse | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113409 | AL | Yes |

## Other

- **Enumeration date:** 06/22/2010
- **Last updated:** 01/15/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000120600 | — | AL |
| 01 | — | 2125450 | PK | — |