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Organization
MEDISTAT RX, LLC
Active
Organization
MEDISTAT RX, LLC
Active
Other names
MediStat RX
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ACKER (CEO)
(855) 737-2550
Entity
Organization
Contact information
Practice address
110 E AZALEA AVE, FOLEY, AL 36535-2540
(251) 923-2525
(866) 310-2803
Mailing address
110 E AZALEA AVE, FOLEY, AL 36535-2540
(855) 737-2550
(866) 310-2803
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
113031
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1996235
PK
—
Enumeration date
01/03/2008
Last updated
12/19/2014
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