Organization
FAF INC
Active
Other names
HealthMart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY WATSON PHARMD (PHARMACY MANAGER)
(256) 705-6499
Entity
Organization
Contact information
Practice address
2015 SPARKMAN DR NW, HUNTSVILLE, AL 35810-3815
(256) 715-7475
(256) 715-7418
Mailing address
2015 SPARKMAN DR NW, HUNTSVILLE, AL 35810-3815
(256) 715-7475
(256) 715-7418
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
113849
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135348
—
AL
01
—
2133532
PK
—
01
—
Q003930001
PTAN
—
Enumeration date
01/18/2012
Last updated
12/29/2020
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