Provider Demographics
NPI:1225168370
Name:TRC PHARMACY INC
Entity Type:Organization
Organization Name:TRC PHARMACY INC
Other - Org Name:HAYES DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-688-2032
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:JEMISON
Mailing Address - State:AL
Mailing Address - Zip Code:35085-0100
Mailing Address - Country:US
Mailing Address - Phone:205-688-2032
Mailing Address - Fax:205-688-2081
Practice Address - Street 1:24724 US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:JEMISON
Practice Address - State:AL
Practice Address - Zip Code:35085
Practice Address - Country:US
Practice Address - Phone:205-688-2032
Practice Address - Fax:205-688-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0114049OtherNABP
AL140780Medicaid