Provider Demographics
NPI:1124189949
Name:PRESCRIPTIONS BY RITA KAY INC
Entity Type:Organization
Organization Name:PRESCRIPTIONS BY RITA KAY INC
Other - Org Name:HERITAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM
Authorized Official - Phone:256-737-3773
Mailing Address - Street 1:1701 MAIN AVE SW
Mailing Address - Street 2:STE C
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5299
Mailing Address - Country:US
Mailing Address - Phone:256-737-3773
Mailing Address - Fax:256-737-3775
Practice Address - Street 1:1701 MAIN AVE SW
Practice Address - Street 2:STE C
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5299
Practice Address - Country:US
Practice Address - Phone:256-737-3773
Practice Address - Fax:256-737-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AL1127043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995715OtherPK
AL100003659Medicaid
1995715OtherPK