Organization
TARA PHARMACY SE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORBERT A BENNETT (CEO)
(716) 662-4955
Entity
Organization
Contact information
Practice address
211 SUMMIT PKWY, SUITE 112, HOMEWOOD, AL 35209-4751
(205) 916-2267
(205) 916-0877
Mailing address
211 SUMMIT PKWY, SUITE 112, HOMEWOOD, AL 35209-4751
(205) 916-2267
(205) 916-0877
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
112737
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510 T115
BCBS OF AL
AL
Enumeration date
02/27/2007
Last updated
08/22/2020
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