Provider Demographics
NPI:1013190487
Name:EAGLE PHARMACY INC
Entity Type:Organization
Organization Name:EAGLE PHARMACY INC
Other - Org Name:EAGLE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:HALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:205-682-7999
Mailing Address - Street 1:2200 RIVERCHASE CTR
Mailing Address - Street 2:SUITE 675
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2866
Mailing Address - Country:US
Mailing Address - Phone:205-682-7999
Mailing Address - Fax:205-682-7616
Practice Address - Street 1:2200 RIVERCHASE CTR
Practice Address - Street 2:SUITE 675
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2866
Practice Address - Country:US
Practice Address - Phone:205-682-7999
Practice Address - Fax:205-682-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1130363336C0003X
3336C0004X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1996234OtherPK
0135005OtherNCPDP PROVIDER IDENTIFICATION NUMBER