# APOTHECARY SHACK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Apothecary Shack Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518614163
- **Authorized official:** MR. ARKEZ FAIR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (334) 593-4242

## Contact information

- **Practice address:** 6120 OLD POST LN, MONTGOMERY, AL 36116-7132
- **Practice address phone:** (334) 593-4242
- **Mailing address:** PO BOX 831182, TUSKEGEE, AL 36083-1182
- **Mailing address phone:** (334) 593-4242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 164W00000X | Licensed Practical Nurse | — | NULL | — |
| 164W00000X | Licensed Practical Nurse | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 175F00000X | Naturopath | — | NULL | — |
| 175F00000X | Naturopath | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 03/03/2022
- **Last updated:** 03/04/2022
