Organization
CAREDIRECT RX OF JACKSON, LLC
Active
Other names
CareDirect Rx of Jackson, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PORTER MCCOLLISTER (MANAGER)
(205) 414-6681
Entity
Organization
Contact information
Practice address
112 CELTIC DR STE 200A, MADISON, AL 35758-1800
(256) 325-2148
(256) 325-2168
Mailing address
PO BOX 531144, BIRMINGHAM, AL 35253-1144
(205) 414-6681
(205) 930-0405
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
114123
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140602
PK
—
Enumeration date
06/18/2013
Last updated
06/18/2013
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