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Organization

HUNTSVILLE GI PHARMACY, LLC

Active
Other names
Huntsville GI Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMIE MISKIMINS (SENIOR OPERATIONS MANAGER)
(817) 572-0009
Entity
Organization

Contact information

Practice address
119 LONGWOOD DR SW, SUITE 200A, HUNTSVILLE, AL 35801-4522
(817) 572-0009
(817) 720-1039
Mailing address
1620 W NORTHWEST HWY, SUITE 100, GRAPEVINE, TX 76051-3177
(817) 572-0009
(817) 720-1039

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
114706
AL
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2168951
PK
Enumeration date
04/20/2017
Last updated
04/20/2017
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