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Organization

MEDAUS PHARMACY AND COMPOUNDING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY DON STEPHENS R. PH. (C.O.O.)
(205) 981-2352
Entity
Organization

Contact information

Practice address
6801 CAHABA VALLEY RD STE 116, BIRMINGHAM, AL 35242-9609
(205) 981-2352
(205) 981-2767
Mailing address
6801 CAHABA VALLEY RD STE 116, BIRMINGHAM, AL 35242-9609
(205) 981-2352
(205) 981-2767

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
111215
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0128149
NCPDP
AL
Enumeration date
10/09/2006
Last updated
08/08/2008
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