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Organization
BRENNCORP INC
Active
Organization
BRENNCORP INC
Active
Other names
MIDTOWN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL WATERS (PRES)
(251) 739-2424
Entity
Organization
Contact information
Practice address
2152 AIRPORT BLVD, MOBILE, AL 36606-1756
(251) 479-2424
(251) 479-5234
Mailing address
2152 AIRPORT BLVD, MOBILE, AL 36606-1756
(251) 479-2424
(251) 479-5234
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
109668
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119366
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100002231
—
AL
Enumeration date
11/17/2006
Last updated
08/23/2010
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