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Organization
HUNTSVILLE GI PHARMACY, LLC
Active
Organization
HUNTSVILLE GI PHARMACY, LLC
Active
Other names
Huntsville GI Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE MISKIMINS (SENIOR OPERATIONS MANAGER)
(817) 572-0009
Entity
Organization
Contact information
Practice address
119 LONGWOOD DR SW, SUITE 200A, HUNTSVILLE, AL 35801-4522
(817) 572-0009
(817) 720-1039
Mailing address
1620 W NORTHWEST HWY, SUITE 100, GRAPEVINE, TX 76051-3177
(817) 572-0009
(817) 720-1039
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
114706
AL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168951
PK
—
Enumeration date
04/20/2017
Last updated
04/20/2017
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