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Organization

HEALTH SERVICES DIVERSIFIED, INC.

Active
Other names
Medicap Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JODI C. SILVIO P.D. (PRESIDENT)
(251) 929-1017
Entity
Organization

Contact information

Practice address
104 ECOR ROUGE PL, FAIRHOPE, AL 36532-3062
(251) 929-1017
(251) 929-1018
Mailing address
104 ECOR ROUGE PL, FAIRHOPE, AL 36532-3062
(251) 929-1017
(251) 929-1018

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
111749
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
111749
AL
333600000X
Pharmacy
111749
AL
3336C0003X
Community/Retail Pharmacy
Primary
111749
AL
3336H0001X
Home Infusion Therapy Pharmacy
111749
AL
3336L0003X
Long Term Care Pharmacy
111749
AL
3336M0002X
Mail Order Pharmacy
111749
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009938825
AL
05
100003187
AL
Enumeration date
07/13/2006
Last updated
07/24/2008
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