Organization
PROFESSIONAL APOTHECARY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE HARRIS RPH (PRESIDENT/OWNER)
(256) 362-8328
Entity
Organization
Contact information
Practice address
210 NORTH ST W, TALLADEGA, AL 35160-2083
(256) 362-8328
(256) 362-8361
Mailing address
210 NORTH ST W, TALLADEGA, AL 35160-2083
(256) 362-8328
(256) 362-8361
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000050787
—
AL
01
—
51050787
BLUE CROSS ALABAMA
AL
Enumeration date
10/25/2006
Last updated
02/24/2015
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