Provider Demographics
NPI:1003452467
Name:FIDELIS SERVUS CORPORATION
Entity Type:Organization
Organization Name:FIDELIS SERVUS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HONEA
Authorized Official - Suffix:II
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-678-7755
Mailing Address - Street 1:16688 HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-8367
Mailing Address - Country:US
Mailing Address - Phone:205-678-7755
Mailing Address - Fax:205-678-0900
Practice Address - Street 1:455 HELENA MARKET PL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-3563
Practice Address - Country:US
Practice Address - Phone:205-729-5060
Practice Address - Fax:205-729-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy