# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF SOUTH ALABAMA
- **Other names:** MCIRx, Mitchell Cancer Institute Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376032847
- **Legal business name:** UNIVERSITY OF SOUTH ALABAMA
- **Authorized official:** CAROLYN DEMOUY (PHARMACY COORDINATOR)
- **Authorized official phone:** (251) 410-6337

## Contact information

- **Practice address:** 1660 SPRING HILL AVE, MOBILE, AL 36604-1405
- **Practice address phone:** (251) 410-6337
- **Practice address fax:** (251) 410-4955
- **Mailing address:** 1660 SPRING HILL AVE, MOBILE, AL 36604-1405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/09/2018
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0143482 | NCPDP | AL |