Organization
FRED C SANDLIN JR
Active
Other names
Freds Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FRED C SANDLIN JR. RHP (OWNER)
(205) 921-3193
Entity
Organization
Contact information
Practice address
797 MILITARY ST S, HAMILTON, AL 35570-4737
(205) 921-3193
(205) 921-2576
Mailing address
PO BOX 36, HAMILTON, AL 35570-0036
(205) 921-3193
(205) 921-2576
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
104160
AL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
104160
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
104160
AL
332BX2000X
Oxygen Equipment & Supplies (DME)
104160
AL
333600000X
Pharmacy
104160
AL
3336C0003X
Community/Retail Pharmacy
104160
AL
3336H0001X
Home Infusion Therapy Pharmacy
104160
AL
3336L0003X
Long Term Care Pharmacy
104160
AL
3336M0002X
Mail Order Pharmacy
104160
AL
3336S0011X
Specialty Pharmacy
104160
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000051121
—
AL
05
—
00330656
—
MS
05
—
00440633
—
MS
05
—
009922585
—
AL
01
—
0107361
BCBS MS
MS
05
—
100003563
—
AL
01
—
1537359
UMWA
—
01
—
510-51121
BCBS
AL
01
—
510-68006
BCBS HIT
AL
Enumeration date
07/17/2006
Last updated
11/20/2013
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