Organization
MONTGOMERY CANCER CENTER LLC
Active
Other names
MCC APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HARRISON RPH (DIR OF PHCY)
(334) 273-2252
Entity
Organization
Contact information
Practice address
4145 CARMICHAEL RD, STE A, MONTGOMERY, AL 36106-2803
(334) 273-2281
(334) 386-2936
Mailing address
4145 CARMICHAEL RD, STE A, MONTGOMERY, AL 36106-2803
(334) 273-2281
(334) 368-2936
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
111763
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0130219
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/20/2006
Last updated
05/09/2012
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